An Evidence-Based Approach to Thumb Carpometacarpal Joint Osteoarthritis

Thumb carpometacarpal (CMC) joint osteoarthritis is a common degenerative disorder in the aging population that can result in pain and hand dysfunction. This condition is a frequent reason for seeking consultation from a hand surgeon and accounts for notable costs to the healthcare system each year. Although the disease is common, the evidence to guide treatment continues to evolve, and treatment variations exist among clinicians. It is important to review the existing scientific evidence across various aspects of care, both nonsurgical and surgical, for thumb CMC joint osteoarthritis. Nonsurgical options for this disease include various brace treatment and splinting options, topical analgesics, and injection treatments. The common surgical treatment options for thumb CMC joint arthroplasty include simple trapeziectomy, but additional procedures such as flexor carpi radialis ligament reconstruction and tendon interposition, abductor pollicis longus suspensionplasty, and suture suspensionplasty are commonly performed. Prosthetic joint arthroplasty options for thumb CMC joint osteoarthritis exist. There is interest in joint-preserving surgical options for thumb CMC joint osteoarthritis, such as thumb CMC joint arthroscopy, thumb metacarpal extension osteotomy, and the emerging technique of thumb CMC denervation.