Advertisement

Surgical Options for Failed Thumb Basal Joint Arthroplasty

  • Scott A. Mitchell
  • Roy A. MealsEmail author
Chapter

Abstract

Failed basal joint arthroplasty can be a very challenging condition to treat. There can be multiple potential sources for continued pain about the base of the thumb. These sources can be neurogenic in nature, but can also represent continued arthritic problems in some of the other small joints of the wrist. In some cases, there may be carpal instability present that is contributing to continued symptoms. In other cases, there may be frank failure of the previous procedure. The reoperative hand surgeon must carefully weight potential treatment options which will depend on what the previous procedure was and what is believed to be causing the symptoms. If the true source of the patient’s continued pain can be identified, frequent improvement in the patient’s symptoms can be achieved with further surgical intervention. However, these patients should be counseled that it is rare for them to ever achieve complete pain relief, but that the surgical goal is improvement in their symptoms.

Keywords

Thumb Basal Joint Arthroplasty Revision Failure 

References

  1. 1.
    Burton RI, Pellegrini Jr VD. Surgical management of basal joint arthritis of the thumb. Part II. Ligament reconstruction with tendon interposition arthroplasty. J Hand Surg Am. 1986;11(3):324–32.PubMedGoogle Scholar
  2. 2.
    Eaton RG, Glickel SZ, Littler JW. Tendon interposition arthroplasty for degenerative arthritis of the trapeziometacarpal joint of the thumb. J Hand Surg Am. 1985;10(5):645–54.PubMedGoogle Scholar
  3. 3.
    Tomaino MM, Pellegrini Jr VD, Burton RI. Arthroplasty of the basal joint of the thumb. Long-term follow-up after ligament reconstruction with tendon interposition. J Bone Joint Surg Am. 1995;77(3):346–55.PubMedGoogle Scholar
  4. 4.
    Gray KV, Meals RA, Gray KV, Meals RA. Hematoma and distraction arthroplasty for thumb basal joint osteoarthritis: minimum ­6.5-year follow-up evaluation. J Hand Surg Am. 2007;32(1):23–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Wagner W. Why ligament reconstruction, tendon interposition arthroplasty failes, and salvaging failed ligament reconstruciton, tendon interposition arthroplasty. Curr Opin Orthop. 2006;17:288–94.CrossRefGoogle Scholar
  6. 6.
    Cooney 3rd WP, Leddy TP, Larson DR. Revision of thumb trapeziometacarpal arthroplasty. J Hand Surg Am. 2006;31(2):219–27.PubMedCrossRefGoogle Scholar
  7. 7.
    Conolly WB, Rath S. Revision procedures for complications of surgery for osteoarthritis of the carpometacarpal joint of the thumb. J Hand Surg Br. 1993;18(4):533–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Renfree KJ, Dell PC. Functional outcome following salvage of failed trapeziometacarpal joint arthroplasty. J Hand Surg Br. 2002;27(1):96–100.PubMedCrossRefGoogle Scholar
  9. 9.
    Kuhns CA, Emerson ET, Meals RA. Hematoma and distraction arthroplasty for thumb basal joint osteoarthritis: a prospective, ­single-surgeon study including outcomes measures. J Hand Surg Am. 2003;28(3):381–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Eaton RG, Littler JW. Ligament reconstruction for the painful thumb carpometacarpal joint. J Bone Joint Surg Am. 1973;55(8):1655–66.PubMedGoogle Scholar
  11. 11.
    Thompson JS. Complications and salvage of trapeziometacarpal arthroplasties. Instr Course Lect. 1989;38:3–13.PubMedGoogle Scholar
  12. 12.
    Diao E. Trapezio-metacarpal arthritis. Trapezium excision and ­ligament reconstruction not including the LRTI arthroplasty. Hand Clin. 2001;17(2):223–36; ix.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryUniversity of California, Los AngelesLos AngelesUSA

Personalised recommendations