Overview
Basal joint arthritis, also known as osteoarthritis of the first carpometacarpal joint, primarily affects the thumb and causes pain, stiffness, and functional impairment. 1Diagnosis
Clinical presentation includes pain at the base of the thumb, especially with gripping or thumb opposition.
Radiographic evaluation often shows joint space narrowing, osteophyte formation, and subchondral cysts.
Functional assessments like Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score can quantify disability. 1Management
First-line treatments: Conservative management including splinting, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections.
Surgical interventions: Trapeziectomy with various arthroplasty techniques; knotless suture anchor suspensionplasty (KSAS) allows early mobilization without pin fixation or casting. 1
Cosmetic considerations: Utilizing a single transverse incision over the trapezium can minimize visible scarring. 2Special Populations
Cosmetic technique relevance: Particularly important for improving patient satisfaction regarding scar appearance post-surgery, applicable across all age groups including elderly patients. 2Key Recommendations
Consider knotless suture anchor suspensionplasty (KSAS) for advanced basal joint arthritis to facilitate early mobilization and potentially reduce complications associated with traditional fixation methods. (Evidence: Weak) 1
Employ a single transverse incision technique during basal joint arthroplasty to enhance cosmetic outcomes and patient satisfaction. (Evidence: Weak) 2
Evaluate functional outcomes using tools like the Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score post-treatment to monitor patient recovery and disability levels. (Evidence: Moderate) 1References
1 Larsen CG, Doering TA, Rinaldi J, Greenberg AS, Birdsong E, Tuckman DV. Knotless Suture Anchor Suspensionplasty for Basal Joint Arthritis A Prospective Case Series with Short-Term Outcomes. Bulletin of the Hospital for Joint Disease (2013) 2022. link
2 Rowland SA. A cosmetic technique for performing Basal joint arthroplasty. Techniques in hand & upper extremity surgery 2005. link