What is Osteoarthritis?
In a normal joint, the surfaces of the bones facing each other are covered with a smooth and regular cartilage tissue. In the disease called osteoarthritis, degenerative arthritis, arthrosis, arthritis or degenerative joint disease, this cartilage layer is worn, deformed, and degenerated. At that stage, bone surfaces come forward underneath this deteriorated cartilage, and bone to bone frictions occur during joint movement. The thumb base joint is the second most frequently seen localization for the osteoarthritis after the finger-tip joints.
Who is Affected by Osteoarthritis?
Osteoarthritis of the hand is generally seen in thumb basal joint and in women older than 40 years of age. It often occurs on their own. Occasionally, osteoarthritis may occur over the years as a result of trauma or injury.
What does Osteoarthritis Mean?
Osteoarthritis means wear and degeneration of the joint including cartilage covering the surfaces of the bone ends inside of the joint.
How does Osteoarthritis Occur?
Although osteoarthritis may occur gradually by itself, it can sometimes occur over the years as a long-term result of an injury or trauma.
Osteoarthritis is Mostly Seen in Three Different Localizations of the Hand
- Tip joints of the fingers
- The base joint of the thumb
- The middle joints of the fingers
Osteoarthritis may occasionally affect the wrist.
What are the Complaints of the Patient Who Has Osteoarthritis?
Swelling and pain in the affected joints are the most common complaints. As the disease progresses, hard nodules are formed around the joints and deformities occur over time.
In particular, active daily usage of the thumb may be very difficult and painful at the osteoarthritis of the base joint of the thumb.
How do Symptoms of Osteoarthritis Begin?
Weakness of the hand gets to be a problem during active daily living. Especially following activities are difficult to perform and painful:
- Opening jars
- Turning the keys
- Scissoring
- Pinching
- Twisting
- Bending
- Writing
Resting pain can also be added as the disease progresses.
How is Osteoarthritis Diagnosed?
Your doctor examines your hand including the affected joint and looks at conditions of potential joints at the hand and throughout the body. Radiological evaluations are performed and the parameters are recorded such as degenerated joint surfaces, narrowing of the joint line, newly formed bony spikes around the joint edges, and the deformities.
What Should be the Purposes of Osteoarthritis Treatment?
- The aim of the treatment is to reduce the pain and to increase the function.
- Anti-inflammatory and analgesic drugs may be useful.
- Resting reduces the pain.
- Splints for the fingers or wrist, and night splints can reduce the pain that affects daily life.
- The physician decides to apply cold or heat depends on the conditions of each patient.
- Cold can be useful if there is severe swelling and inflammation.
- In case of painful deformities, sometimes hot paraffin applications are performed.
- With physical therapy exercises, function of the hand is increased.
- In some severe cases, steroid injections may be used.
How Should the Treatment Be Performed at the Basal Joint Joint of the Thumb Osteoarthritis?
At the beginning of osteoarthritis, following modalities can be performed;
- Medications
- Splints
- Intra-articular steroid injections
- Physical therapy methods
At the late stages or the disease do not respond to these treatment methods, surgical alternatives may be considered.
The purposes of osteoarthritis surgery are;
- To get rid of pain
- To increase the function of the thumb and the hand.
There are many surgical techniques. Depending on the stage of the disease and the personal lifestyle and general health status, your doctor will tell you the most appropriate operation.
When Should Surgical Intervention be in Consideration of Osteoarthritis Patients?
If conservative treatments do not work, surgical treatment alternatives are considered in some cases. Surgical treatment possibilities may occur if there are severe painful conditions and decreased function.
What is the Purpose of Osteoarthritis Surgery?
The aims of the surgery are to increase the function, eliminate the pain or reduce it to an acceptable level. One of the most commonly used operations is to fuse the joints. In this kind of surgery, deformity and curvature are corrected, the joint is fused and the pain is completely eliminated.
What Does Arthroplasty Mean?
The second treatment alternative is arthroplasty.
Arthroplasty, which means joint reconstruction, is a surgery includes soft tissue interposition or prosthetic replacement to the cavity formed after the removal of the diseased joint. In this kind of surgery, the deformity is corrected and the motion is preserved. The most appropriate surgical treatment is chosen according to the patient’s life style, active daily living, and the degree of the disease.