This current concepts review from J Hand Surgery 2015 addresses diagnosis and surgical management of osteoarthritis at all three thumb joints — TMC, MCP, and IP — synthesizing systematic reviews, RCTs, and expert opinion to guide treatment selection across disease stages.
When a patient with thumb basal joint arthritis fails conservative care, stage them with Eaton-Glickel and default to simple trapeziectomy with hematoma-distraction arthroplasty — the evidence shows no functional advantage to more complex LRTI reconstructions, and the complication rate is half.
Always assess MCP hyperextension concurrently, as deformity exceeding 30° requires simultaneous stabilization to prevent persistent instability after TMC reconstruction.
This current concepts review from J Hand Surgery 2015 addresses diagnosis and surgical management of osteoarthritis at all three thumb joints — TMC, MCP, and IP — synthesizing systematic reviews, RCTs, and expert opinion to guide treatment selection across disease stages.
When a patient with thumb basal joint arthritis fails conservative care, stage them with Eaton-Glickel and default to simple trapeziectomy with hematoma-distraction arthroplasty — the evidence shows no functional advantage to more complex LRTI reconstructions, and the complication rate is half.
Always assess MCP hyperextension concurrently, as deformity exceeding 30° requires simultaneous stabilization to prevent persistent instability after TMC reconstruction.