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Maybe it’s writing a note, opening a jar, or dialing a number on your phone: When you have thumb carpometacarpal (CMC) joint arthritis, these tasks can feel excruciatingly painful and barely doable. CMC arthritis means that patients have painful arthritis at the base of their thumb, where the thumb and wrist meet. As cartilage in the area wears down, the ends of each bone rub together, causing intense pain and discomfort, and limiting a person’s functionality and how they can use their thumb and wrist in everyday activities.
Is CMC joint surgery really necessary?
In plenty of patients with CMC arthritis, physicians will recommend CMC joint surgery…but is it truly necessary? If you have debilitating or even moderate CMC arthritis pain, your doctor may have advised you to undergo thumb or hand surgery. The most common form of CMC joint surgery is to remove all or part of the wrist bone that comprises the base of the thumb joint. The idea behind this surgery is that, if the joint is causing a patient pain, the joint should be removed.
However, there are myriad problems with removing the thumb joint as the source of arthritic pain. Once the joint is removed between the base of the thumb and the wrist, that area will collapse under the pressure of the thumb.
How is this remedied? One option is to take a tendon from the hand and coil it up and stuff it into the space that would be collapsed. Recent research, however, shows that this fix is associated with twice as many side effects as normal. Another option is to drill a rubber band-like device into the bone of the thumb and adjacent bones to keep the area at the base of the thumb from collapsing. Unfortunately, there are no non-invasive aspects to this type of joint surgery.
Does CMC joint surgery work? Will it eliminate my pain?
Unfortunately, there is little to no high-level evidence that invasive procedures like CMC joint surgery work well in most patients. While there are different high-level studies on the different surgical options and procedural choices available to surgeons, they are very small studies.
Additionally, most patients are under the false impression that, because surgery is often suggested as a last resort in the clinical decision tree, after more conservative treatment options like drugs or physical therapy, CMC joint surgery must be a definitive end to their pain problems. There is a common assumption that, after surgery, all of the patient’s thumb pain will subside and all normal hand function will return, pain-free. Sadly, the little research the medical community does have on these surgeries does not paint that picture of recovery.
On average, patients who have undergone CMC joint surgery will still have mild to mild-moderate pain in their joints. Even more concerning is the data that shows that patients also continue to report mild to moderate loss of hand function post-surgery. On top of all of these potential post-surgical outcomes, there is a very high complication rate of 22% in the most common method of CMC joint surgery, which is the aforementioned joint removal plus tendon insertion, or trapeziectomy and tendon interposition. As one can see, when the research is done, there is no lasting proof that CMC joint surgery will solve arthritic problems, and could actually cause lasting detrimental side effects.
Is there an alternative to CMC joint surgery if I’m not sure I want to undergo surgery at all?
Thankfully, there is an alternative to this type of invasive surgery, and it is one we practice at Centeno-Schultz. Our approach to orthopedic care, and an alternative to CMC joint surgery, is called Interventional Orthopedics. Our Percutaneous CMC Arthroplasty Procedure (also called a Perc-CMC Arthroplasty for short) is for the CMC, thumb/basal joint, and it is a non-surgical treatment that has truly been a breakthrough for our patients suffering from pain, reduced range of motion due to basal joint arthritis, or other more long-term degenerative problems in the hands.
Our patented protocol alternative to CMC joint surgery is far more complex than patients will find at other clinics; everything about this treatment is designed for results. The Perc-CMC Arthroplasty is non-invasive, and treatment recovery calls for minimal downtime or missed working hours. We have extensive published patient outcome data on the effectiveness of our procedure, which involves precise, image-guided injections performed by musculoskeletal specialist physicians. Before you consider CMC joint surgery as a solution to your arthritis problems, explore alternatives and options outside of surgery, and allow our team to show you what makes our clinic unique, and determine whether you are a candidate for our alternative Perc-CMC Arthroplasty procedure.
Ready to find relief?
Life is too short to live in pain. If you’ve been recommended hand surgery, we want to provide you an alternative that minimizes complications and ensures optimal and lasting results. Take advantage of our innovative treatments that help people just like you avoid CMC joint surgery and other invasive surgeries, allowing them to get back to doing the activities they love, faster and without surgery.