HAND EMERGENCIES 24H/24 nl fr

Rhizartrose

The joint is composed of two bony surfaces covered with cartilage. Osteoarthritis occurs when the cartilage wears out: the surface cracks, deteriorates and finally disappears. Bone spurs are then formed which hamper movement. This condition is typically linked to ageing.

Rhizarthrosis is a form of osteoarthritis that appears at the base of the thumb. It mostly affects women.


Rhizarthrosis: symptoms and diagnosis

Rhizarthrosis is often well tolerated despite significant radiological signs. This osteoarthritis of the thumb can cause episodic pain which is sometimes intense, as a result of direct pressure or a movement.

These pains are accompanied by swelling and the gradual stiffening of the thumb-index pinch, with a reduction in strength and even deformity of the finger.
An x-ray is essential to confirm the diagnosis because it allows the degree of cartilage wear to be ascertained.


Rhizarthrosis: treatment and progression

Medical treatment

The patient is offered medical treatment first:

• Hyaluronic acid or corticosteroid injections
• A nocturnal splint

Surgery

In advanced cases or for patients who don’t respond to medical treatment, the joint may be replaced by a prosthesis.
Compared with other surgical procedures, a prosthesis allows the patient to regain hand strength and movement.

The operation is performed at a day clinic under locoregional anaesthesia. After the thumb has been immobilised for three weeks, functional recovery is achieved through ‘self-rehabilitation’ and the pain quickly disappears.

If joint replacement isn’t an option, the surgeon will carry out a trapeziectomy to completely remove the trapezium in order to eliminate the source of the osteoarthritic pain. Recovery of strength and movement is longer compared with joint replacement. The consequences of this type of surgery are also more restrictive.