Trapeziectomy Versus Carpometacarpal Arthroplasty for Basilar Thumb Arthritis: A Narrative Review of Comparative...

Basilar thumb arthritis or thumb carpometacarpal (CMC) joint osteoarthritis is a common degenerative condition causing pain, weakness, and functional limitation, particularly among older populations and postmenopausal women. Surgical intervention is often required for advanced disease, with trapeziectomy and prosthetic arthroplasty being the two main approaches. Trapeziectomy, with or without ligament reconstruction and tendon interposition (LRTI), provides reliable long-term pain relief and functional restoration. Prosthetic arthroplasty aims to preserve thumb length, maintain biomechanics, and enable faster rehabilitation. This review synthesizes evidence comparing trapeziectomy-based procedures and CMC arthroplasty, focusing on pain, functional outcomes, strength, range of motion, complications, implant survival, rehabilitation, and patient satisfaction. Both approaches achieve excellent outcomes, with arthroplasty offering earlier functional gains but higher implant-specific complications and revision rates. Trapeziectomy remains a durable, cost-effective, and predictable treatment option. Individualized patient selection and shared decision-making are emphasized, and long-term comparative studies are needed to refine surgical guidelines.