Chirurgische Praxis Alstertal Heegbarg 14 22391 Hamburg Tel: +49 (0) 40 602 30 06
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Rhizarthrosis – Therapeutic options Rhizarthrosis – Osteoarthritis CM1

Handsurgeon and Surgical Practice Alstertal Handchirurg Dr. Stefan Peters Tel. 0049-40-6023006

Here, Dr. Peters shows the common therapeutic options, starting with simple noninvasiv and ending invasiv procedures. Not all possible is shown. This page reflects Dr. Peters long term experience in useful therapy.


thumb splint


Advantage: easy, no stress on the patient. Public health insurance with an additional payment.

Disadvantage: help is usually mild. Exposure by limiting the thumb mobility in everyday life. The condition of the joint remains. Most complaints increase as soon as the thumb is no longer supported.

Rating: At least helpful in few cases In summary not recommended.



Advantage: depending on situation temporarily good pain relief and reduction of joint irritation.

Disadvantage: In the long run all pain medications decreasing their effect by habituation, side effects are potentially harmful.

Rating: shortly for acute Pain good; in the long run not an option!


Injection of liquid Cartilange acid (hyaluron injection) in the CM 1 joint.

Advantage: No pain, injection with a small syringe . Quite long duration of pain reduction after injection. No unwanted side effects. Repeated injections easy.

Disadvantage: effect uncertain. Some patients have fewer symptoms for months after an injection. In others, the osteoarthritis symptoms have not decreased after injection. (The success is unpredictable.) No permanent solution. Not payed by public health insurance. (Most private health insurance companies cover the cost)

Rating: If therapy responsive, thoroughly recommended. But even this can not predicted.


Cortisone injection into CM1 joint

Advantage: Helps usually good. Duration 3 to 6 months. Apart from the puncture nophysical strain. The negative effects of cortisone on the whole organism are negligible when injection a small amount of cortisone.

Disadvantage: Can be repeated only 2 to 3 times, otherwise it may come in the area of injection to damage to all tissues. Sucess needs a few days. Initial even Pain gain is possible.

Rating: considered pragmatically, often useful. No permanent solution. Many patients are almost free of symptoms for months after the injection; acceptance is quite good. Dr. Peters is “not a fan” of this method, but it has its place in the treatment of carpometacarpal joint osteoarthritis.


Arthroplasty with placeholder (spacer)

Advantage: outpatient basis in LA. Good success rate, relatively rapid success, See also OP description. If unsuccessful, the removal of the entire saddle joint bone (standard method) is possible.

Disadvantage: Not a long proven standard method (see below). Lasting success to date not predictable. (Positive experiences over three years exist).

Review: The operation, conducted by Dr. Peters arthroplasty is, if successful, a simple and less burdensome method as the so-called gold standard. Dr. Peters operated uses exclusively this established method. The demand for this method by the patient is high, the so called gold standard (suspension plastic) is not accepted by many patients because oft he long term reconvalescence.


Suspension plastic

Advantage: So called “gold standard” in hand surgery, proven over decades. Usually lasting success.

Disadvantage: Long-treatment, long incapacity. Increased postoperative pain on the patient. Patient satisfaction +/- 90%

Review: The results are mostly good. The up to 1/2 year-long treatment after operation is according to Dr. Peters, however, a significant drawback and therefore not considered by many patients.

Disclaimer Info Pages

 Dear Patient, this page is made to inform you and provides essential information about medical issues.

We have published this page in good faith and based on our years of experience and  latest scientific findings.

Of course, a guarantee for  correctness and completeness can not be given in the rapidly-developing field of medicine. Even other doctors may disagree. 

However, we are convinced: You will be informed  useful and responsible. Nevertheless, we encourage you to gather information  also from different sources.


  • Dr. med. Stefan Peters
    Trauma Surgery
    General Surgeon

    Dr. med. Stephan Berg
    General Surgeon
    Trauma Surgery

  • Hours of Service

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    Monday to Friday 8:00–18:00 clock

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