TMC Joint Replacement Surgery

www.handandwristinstitute.com/... -One of the most common places to develop arthritis in the hand is at the TMC joint, which connects the thumb to the rest of the hand. It is also, unfortunately, one of the most physically debilitating. Forceful gripping and grasping, especially when paired with a torqueing motion of the wrist, tend to exacerbate development of injuries in this area.
Located between the trapezium in the wrist and the metacarpal of the thumb, the TMC joint is saddle-shaped, and is important in the mobility of the thumb, especially in its relationship to the fingers. Degenerative arthritis and daily overuse of the joint, which can cause the ligaments to lose some of their tautness, as well as different fractures and other forms of arthritis (inflammatory and Rheumatoid) can be contributing factors in TMC issues.
As the injury involves the bones of the wrist and hand, x-rays are the most commonly employed, and most effective, methods of diagnosing this problem.
Conservative treatment of TMC injuries is usually a regimen of rest, which should allow the joint to repair itself. NSAID anti-inflammatory medication is also effective in reducing symptoms, as well as use of a thumb spica splint while the patient is sleeping. If these prove ineffective, then a cortisone injection may be a possible treatment, but this is only if all else fails.
When symptoms continue unabated, especially when the patient is at rest, then the injury may be treated surgically. Two incisions are made over the TMC and the thumb metacarpal and the triquetrum is taken out of the joint, leaving a space. The bones are noosed together using a heavy suture through the bones, and the open space can be filled with a ball made of tendon tissue taken from other parts of the arm. New developments in procedure, however, make this generally obsolete in treatment.
Splinting for one week will be necessary after surgery, after which time a removable brace will be employed for one month. At that point, therapy will be engaged for two months, to return function to the joint.
In most cases, this surgery is 95% effective in the resolution of symptoms and return of function. Unfortunately, surgery generally does not return full strength to the joint, due to the restructuring of the joint.