The good news, Dr. Koman says, is that many of the procedures successfully relieve the debilitating pain caused by osteoarthritis in the thumb joint. Here we look at some of the surgical options.

Golden Oldie: Removal of Wrist Bone

Removing all or part of the trapezium, a small, square bone that sits under the long bone of the thumb, is a technique that has been used since the 1930s. It is still a surgical standard for arthritis of the lower thumb joint.

Removal of the trapezium is one of the easiest kinds of thumb surgeries, and it reliably relieves pain. It also eliminates the possibility that arthritis could return, but there are some drawbacks. Patients report that they lose strength in their thumbs, making it difficult to grasp and hold objects. It also shortens the thumb significantly, presenting a cosmetic problem.

To solve those issues, surgeons may perform a modified version of this surgery, where the trapezium is removed and the remaining bones are wrapped and stabilized with fine wires.

A study published in the December 2008 issue of the journal Hand, comparing the results of three different kinds of thumb surgeries for arthritis found that patients who opted for this technique, called trapeziectomy with hematoma distraction arthroplasty, had results that were just as good – in terms of both pain relief and strength – as patients who had lengthier, more invasive procedures.

Nothing Fishy: “Anchovy” Surgery

Anchovy surgery is the nickname for a procedure called tendon interpositional arthroplasty.

The procedure involves using tissue from a forearm tendon and curling it – giving it the appearance of an anchovy – to create a cushion between the bones of the joint. “Essentially the tendon tissue becomes a big scar ball,” said Brian Hartigan, MD, a hand surgeon at Northwestern Orthopedics Institute in Chicago.

Artificial “anchovies” are also available. That is, instead of pulling a tendon from the forearm, a synthetic cushion is made from Dacron – a type of polyester commonly used in wrinkle free clothing.