Chirurgische Praxis Alstertal Heegbarg 14 22391 Hamburg Tel: +49 (0) 40 602 30 06

Carpo-Metacarpal osteoarthritis thumb – Rhizarthrosis – Thumb arthritis – Thumb pain

Hand Surgery and Surgical Practice Alstertal Hamburg Poppenbüttel – Tel: +49-(0)40 602 30 06


Caused mostly by “normal” use of the Thumb over decades. Pain in the thumb to wrist when used, typical increasing in rotary motion. Causes are not always severe symptoms; many people get along well without medical assistance.

the marked area = CM 1 joint

the marked area = CM 1 joint

With increasing age, so does the incidence of osteoarthritis. The carpometacarpal joint osteoarthritis occurs in women often already with 40 years, in men a little later.


Click here for detailed anatomical information


App. 80% Of the affected do not require medical assistance. As long as the symptoms are mild and the quality of life is good.


short term and non-operational:

Injection of Hyaluronacid in the joint. Sucess is not predictable. Some have good results, other feel no pain relief. If good, works several months. Can theoretically repeated indefenitly.

Cortisone injection,

Pain relief and antinflammatoric medication is widespread, but in long term not an option.

If quality of live is reduced, then surgical treatment of carpometacarpal joint arthritis should be considered.
Ultimately, advice of an experienced hand surgeon is needed the to find the fitting solution for every person who is affected . Click here for detailed therapeutic options


Operating room


Arthroplasty is the preferred method by Dr. Peters: bone Chip removal, spacer implantation and nerve capping), performed on an outpatient basis under local anesthesia.

Arthroplasty with organic fabricated material
If the above-described “arthroplasty” not have provided sufficient pain relief, so can be introduced into the joint space, alternatively, a cushion pad (company Scaffdex). This pad then resolves itself within 2 years, (since it consists of lactic acid, the body can eliminate it) ie there remains no foreign material in the body. This values Dr. Peters as a good method. Potential drawback, however: Until the Pad is resorbed,of course there is artificial material in the joint space. Should an infection occur, operative revision and Pad removal is mandatory. Conclusion: Dr. Peters provides a safe and successful operative procedure with arthroplasty. In case of failure, the “Pad” insertion offers an easy and comfortable second try for the patients.

Click here to read a detailed OP description .

Benefits: No long treatment, only a few days cast. OP outpatient under local anesthesia, follow-up operations in the (rare) unsuccessful findings possible.

Disadvantages: whether the success is permanent, can not be determined on the basis of previous experience. There are by Dr. Peters operations experiences over about 3 years. Problems have not yet occurred in this time. Satisfaction rate> 90%.


Suspension Plastic
Even a complete removal of the Os Trapezium (saddle joint bone) is possible. Disadvantage: long treatment/physiotherapy necessary (3 to 6 months), several weeks cast immobilization, initially significant discomfort, patient satisfaction at 80%, If lack of success,operational improvement can be problematic.

Advantage: Applies with most hand surgeons as a “gold standard”. The success, unless you count the 80% contented, permanent. Recurrence of symptoms rarely.

Joint prosthetics
Also, the joint replacement with an Prothesis has to be discussed. From the perspective of Dr. Peters, this method has not been enforced since: Loosing fixation after several years are frequent. Rescue operations are difficult. Needlessly foreign material in the body, because the operations described above come more easy to a better result.

What’s next

In the author preferred method, arthroplasty few days immobilization with a cast. Physiotherapy makes sense. Mostly Symptom-free after about 6 weeks.


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  • Dr. med. Stefan Peters
    Trauma Surgery
    General Surgeon

    Dr. med. Stephan Berg
    General Surgeon
    Trauma Surgery

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