Refer a patient to Duke Orthopaedics or learn more about the Duke Hand and Upper Extremity Program (PDF).
Duke Health hand surgeons have introduced an improved prosthesis for moderate to severe osteoarthritis (OA) at the base of the thumb, also called osteoarthritis of the trapeziometacarpal or thumb carpometacarpal (CMC) joint. With the new implant, “we’re seeing patients achieve painless motion within two to four weeks,” says Duke Health hand and upper extremity surgeon Tyler Pidgeon, MD. “At six weeks, they’re back to baseline and returning to all activities.”
The implant, recently granted premarket approval by the FDA, constitutes a marked improvement over prior procedures, which required removal of the trapezium for most patients and a form of suspensionplasty. “Previous surgeries required three months for patients to recover and feel as though it was worthwhile,” Pidgeon says.
“We’re happy to see any patient from early to severe arthritis,” Pidgeon notes. “If a patient complains about pain at the base of the thumb, make the referral at that time.”
Duke Health offers related resources for incoming patients in this area, including:
- Duke Joint Health Program, specializing in treating osteoarthritis of the hip, knee, shoulder, and thumb CMC joints.
- Learning to Manage Chronic Joint Pain and Preparing for Joint Replacement Surgery, a blog post including the patient experience of the Joint Health Program
- Duke Health Osteoarthritis Treatment for general information
Improving CMC replacement
In addition to faster recovery time, the new implant also restores the thumb’s length and alignment. “Other surgeries are a salvage, robbing Peter to pay Paul,” says Pidgeon.
Prior methods remove parts of the anatomy, further shortening the thumb and leading to imperfect alignment. This misalignment often leads to hyperextension of the metacarpophalangeal (MCP) joint, which may require another corrective surgery with the associated scarring and rehabilitation.
“This surgery restores length, helps with function, and allows the MCP joint to realign,” says Pidgeon. “For the vast majority of patients, they achieve nearly full mobility after surgery.”
Furthering research
The new implant, the Touch CMC 1 (KeriMedical Medartis Group, Plan-les-Ouates, Switzerland), has already been in use in Europe for almost a decade. Five-to-eight-year follow-up data indicate that patients have seen reduced pain, increased grip strength, and reduced deformity in the short and medium term.
Along with fellow Duke Health hand surgeons Warren C. Hammert, MD, and Marc J. Richard, MD, Pidgeon traveled to Europe to train on the new implant. As the implant rolls out in the U.S., Duke will lead data collection. “We’ve been selected to be the main site for American research on this type of implant,” says Pidgeon, who will serve as the principal investigator.
Pidgeon encourages referrals for hand and upper extremities: “We’re full service. Anything a provider needs help with from fingertip to shoulder, Duke is able to care for.”
