Thumb Arthritis Surgery (CMC Arthroplasty)
Surgery for arthritis at the base of the thumb with Dr. Steven Ward in Tucson and Oro Valley — rebuilding the worn joint to relieve pain with pinching and gripping, or fusing it when a strong, stable thumb matters most.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The carpometacarpal (CMC) joint at the base of the thumb lets the thumb swivel, pivot, and pinch. It is one of the most common places for osteoarthritis in the hand, especially in women and people over 50.
- Pain at the base of the thumb with pinching, gripping, turning a key, or opening a jar
- Aching after use, and sometimes pain at night
- Weak grip or pinch
- Swelling, a bony bump, or a thumb that starts to angle or collapse in advanced cases
X-rays confirm the diagnosis. Many people with thumb arthritis also have carpal tunnel syndrome, so Dr. Ward will check for that too.
Is surgery right for you?
Thumb CMC arthritis is not dangerous, and many people manage well without surgery:
- A splint that supports the base of the thumb during activities or at night
- Changing how you grip and pinch, and using helpful tools
- Ice and anti-inflammatory medication by mouth or as a gel, when it is safe for you
- Hand therapy exercises
- A steroid injection into the joint, which may help for a while
Surgery is considered when pain and loss of function continue despite these steps. Plan ahead: people with desk jobs may be back to work within a few days, while people with physically demanding jobs often need 2–3 months off.
How the surgery is done
Thumb CMC surgery is almost always an outpatient procedure and takes about 30–60 minutes. A nerve block may be used to numb the arm. The options include:
- Trapeziectomy with tendon reconstruction — the small wrist bone at the base of the thumb (the trapezium) is removed, so there is no longer an arthritic joint. A nearby wrist tendon is used to support and cushion the thumb (often called LRTI)
- Suspension arthroplasty — after the trapezium is removed, the thumb is held up with a tendon sling or a strong suture so it does not sink into the space
- Fusion — the joint surfaces are removed and the bones are held together to heal as one. This gives a strong, pain-free pinch but less thumb motion, so it is usually reserved for people with heavy hand demands
Research has not shown one approach to be clearly better than the others. Dr. Ward will talk with you about which fits your hand and your activities.
Good to know
Most people are happy with the result and have much less pain, but some loss of pinch strength is expected even with an excellent outcome.
Numbness over the back of the thumb tip is common early on from irritation of small skin nerves and usually improves with time. Recurrence is rare.
Recovery overview
Typical ranges only, based on AAOS OrthoInfo patient education. Dr. Ward’s plan for you may differ.
Weeks 0–2
- Dressing and splint usually stay on for 10–14 days
- Keep the hand elevated and move the fingers that are free
- Many people manage pain with acetaminophen and ibuprofen when these are safe for them
- If you had a block, the arm will be numb and weak for a few hours
Weeks 2–8
- After 10–14 days, the dressing comes off and you can shower; do not soak the incision in a pool, hot tub, lake, or ocean for about 30 days
- A removable splint and gentle thumb motion with therapy, with a total of about 4–8 weeks in a cast or splint depending on the procedure
- Some patients are immobilized longer, up to 2–3 months, before starting therapy
Months 3–12
- Soreness and stiffness for several weeks are normal
- It usually takes about 3 months for the surgery to start feeling worthwhile
- Grip strength keeps improving for 9–12 months
- Heavy-labor jobs often need 2–3 months off work
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Fingers that turn pale, blue, or cold
- Numbness or tingling in the hand or fingers that does not go away once the nerve block or numbing medicine has worn off, or that is getting worse
- A cast, splint, or dressing that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise your hand above your heart and gently move your fingers. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, and ice
It is normal for the hand and fingers to be swollen, bruised, and sore for a while, and for the hand or arm to stay numb and weak for several hours after a nerve block or numbing medicine. Keep your hand raised above your heart, and move the fingers that are not splinted as you were shown. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Exercise guides
Hand & wrist handouts, including carpal tunnel exercises and hand and finger exercises.
Open pagePatient resources
Surgery packets, pre-op and post-op instructions, exercise guides, and videos in one place.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pagePhysical therapy locations
Find a therapy clinic near you in Tucson and Oro Valley if hand therapy is part of your plan.
Open pageOrthoInfo: Thumb CMC arthroplasty
Patient education on thumb CMC arthroplasty from the AAOS.
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