This 2011 systematic review evaluates the 8 most commonly used surgical procedures for primary thumb CMC osteoarthritis, synthesizing 35 studies (including 9 not captured by prior reviews) to determine whether any technique is superior in pain, function, strength, or range of motion.
When counseling a patient on surgery for thumb CMC arthritis, no technique has proven definitively superior — choose based on patient age, activity demands, and disease stage — but be prepared to justify LRTI: it adds operative time, carries twice the complication rate of simple trapeziectomy, and its theoretical long-term strength benefit has never been demonstrated in trials exceeding one year.
If considering arthrodesis, quote nonunion rates of 8%–21% and higher reoperation rates during informed consent.
This 2011 systematic review evaluates the 8 most commonly used surgical procedures for primary thumb CMC osteoarthritis, synthesizing 35 studies (including 9 not captured by prior reviews) to determine whether any technique is superior in pain, function, strength, or range of motion.
When counseling a patient on surgery for thumb CMC arthritis, no technique has proven definitively superior — choose based on patient age, activity demands, and disease stage — but be prepared to justify LRTI: it adds operative time, carries twice the complication rate of simple trapeziectomy, and its theoretical long-term strength benefit has never been demonstrated in trials exceeding one year.
If considering arthrodesis, quote nonunion rates of 8%–21% and higher reoperation rates during informed consent.