Trapeziectomy with Ligament Reconstruction and Tendon Interposition

If you need a trapeziectomy, please Schedule an appointment with one of our orthopedic specialists as soon as possible.

What Is Trapezectomy?

Trapeziectomy with ligament reconstruction and tendon interposition is a surgical procedure used to treat arthritis at the base of the thumb, also known as thumb carpometacarpal (CMC) arthritis. This surgery aims to relieve pain, improve function, and restore stability in the thumb joint. Since the thumb is essential for gripping, pinching, and performing everyday tasks, this surgery can significantly improve quality of life. If conservative treatments like splints, physical therapy, or medications fail to provide relief, surgery may be recommended.

Causes of Thumb CMC Arthritis

Thumb CMC arthritis develops when the cartilage in the joint between the trapezium bone (at the base of the thumb) and the first metacarpal (bone in the palm) wears away. This leads to bone-on-bone friction, causing pain, swelling, and reduced function. Several factors can contribute to this condition:

Aging: As people age, the cartilage in the thumb joint naturally deteriorates.
Repetitive Use: Repetitive gripping or pinching activities, such as typing or heavy manual labor, increase the risk.
Injury or Trauma: Previous thumb injuries, fractures, or dislocations can lead to arthritis in the CMC joint.

Symptoms of Thumb CMC Arthritis

Thumb CMC arthritis presents several symptoms:

Pain: Pain at the base of the thumb, especially with gripping, pinching, or twisting motions.
Swelling and Stiffness: Swelling and stiffness at the base of the thumb limit movement.
Weakness: Difficulty holding objects or performing fine motor tasks like writing or buttoning clothes.
Deformity: Over time, the joint may deform, with a visible bump at the base of the thumb.

The Trapeziectomy Procedure

Trapeziectomy with ligament reconstruction and tendon interposition addresses these symptoms by removing the trapezium bone and reconstructing the thumb joint. Here’s a step-by-step overview:

Incision: The surgeon makes a small incision at the base of the thumb to access the CMC joint.
Trapeziectomy: The surgeon removes the trapezium bone to eliminate bone-on-bone friction.
Ligament Reconstruction: The surgeon reconstructs the ligaments using a tendon, often taken from the patient’s own body, to provide added stability.
Tendon Interposition: The surgeon places a tendon graft in the space where the trapezium was, cushioning the joint and absorbing shock.
Closure: The surgeon closes the incision with sutures and applies a bandage to protect the area.

The entire procedure typically takes 1 to 2 hours. Most patients can go home the same day, as it is done on an outpatient basis.

Recovery and Rehabilitation

After trapeziectomy with ligament reconstruction and tendon interposition, doctors usually advise wearing a splint or cast for several weeks to protect the thumb and aid healing. Pain management during recovery typically includes prescribed medications and ice therapy to reduce swelling.

Physical therapy plays a crucial role in recovery. Initially, therapy focuses on controlling swelling and gently improving range of motion. As healing progresses, therapy shifts to strengthening the thumb and increasing flexibility. Most patients resume light activities within 4 to 6 weeks, although full recovery may take several months.

Patients should avoid heavy lifting or strenuous activities until cleared by their orthopedic surgeon.

Benefits of Trapeziectomy with Ligament Reconstruction and Tendon Interposition

This surgical approach offers several benefits:

Pain Relief: By removing the damaged trapezium bone and reconstructing the joint, patients often experience significant pain relief.
Improved Function: The surgery restores thumb stability and strength, improving the ability to perform daily tasks like gripping, typing, and lifting.
Long-Lasting Results: Trapeziectomy with ligament reconstruction and tendon interposition effectively treats thumb arthritis, providing long-term relief from pain and disability.

If you would like to speak to an Orthopedic Specialist, give us a call at 817-697-4038, or contact us over the web. Tele-medicine appointments are also available.