Patient consent obtained to share this case.
A 62-year-old male presented with bilateral thumb carpometacarpal (CMC) joint osteoarthritis, left side worse than right, resulting in progressive pain and functional limitation despite extensive non-surgical management.
Over a two-year period, he trialled a range of conservative treatments including splinting, multiple corticosteroid injections, and structured hand therapy. Despite these measures, his symptoms continued to worsen and significantly impacted his daily function.
On examination, there was tenderness over both thumb CMC joints, more pronounced on the left. A grinding sensation was noted in the left thumb, and thumb opposition was reduced bilaterally. Imaging confirmed mild degenerative change on the right and moderate osteoarthritis on the left, with associated cystic change.
Given the persistence of symptoms and failure of conservative management, a decision was made to proceed with surgical intervention. Mr Richard Pennington (Upper Limb Surgeon at TOC) performed a left thumb CMC joint replacement using a Touch prosthesis.
The alternative surgical option for this condition is a trapeziectomy with ligament reconstruction. In this case, the decision to proceed with joint replacement was made collaboratively with the patient, with the goal of achieving improved early strength, function, and a faster recovery profile.
This represents an interesting and relatively uncommon case, with an excellent post-operative outcome and return of function.
Please note that each case is unique, and treatment options will always be discussed with you during your consultation.
For more information or to book a consultation with one of our Upper Limb Surgeons, please contact The Ortho Clinic at admin@theorthoclinicmelbourne.com.au.