Dr. Anjan Kaushik is Fellowship-trained in hand, wrist, and elbow surgery and can provide specialized care. If your pain is not improving or you have had a recent injury that results in a change in your daily function, please call our office and request an appointment at (765) 521-7385.
He cares for many conditions including:
OSTEOARTHRITIS OF THE HAND
THUMB BASAL CMC JOINT ARTHRITIS
Arthritis at the base of the thumb, known as carpometacarpal (CMC) joint arthritis, is a gradually progressive condition of the thumb from degenerative ‘wear and tear’ and instability. This joint, which serves as a junction between the thumb metacarpal bone and the remaining wrist bones, sees a large number of forces in multiple directions. As a result, the ligaments that stabilize the thumb CMC joint can become lax or rupture over time, and this leads to instability and eventually arthritis. Sometimes an injury to the thumb basal joint (such as a fracture or dislocation) can also lead to post-traumatic CMC arthritis.
Females are more likely than men to have symptoms of basal joint arthritis, and this may be associated with hormone changes around the time of pregnancy and menopause. However, men also commonly develop arthritis at this joint. There has been some evidence for a genetic predisposition for arthritis in this joint, so it is common to see affected family members across multiple generations. In addition, patients with conditions of excess joint laxity such as Ehlers-Danlos syndrome are more at risk to develop thumb CMC arthritis.
Symptoms of thumb CMC arthritis include pain with pinching and gripping, and weakness with daily activities such as handshaking or jar opening. Carpal tunnel syndrome, which presents with hand tingling and numbness, also commonly occurs along with thumb CMC arthritis. X-Rays can be taken to evaluate for the severity of arthritis, but CT or MRI are usually not necessary. A patient’s clinical symptoms may not always correlate with the degree of arthritis on X-rays, so treatment should be directed toward painful or unstable arthritic joints.
Non-surgical treatments are oriented toward symptom relief but do not remove the arthritis from the basal joint. These options include thumb braces, anti-inflammatory medications, physical / occupational therapy for ergonomic adaptive devices and strengthening of muscles around the thumb, and steroid injections in the thumb CMC joint. Injections often provide significant relief but are temporary in effect. There are many surgical techniques for treatment of thumb basal joint arthritis. The most common procedures involve removal of the trapezium (the bone most severely affected) and some form of reconstruction of the ligaments around the thumb base to stabilize the metacarpal bone. Tendons near the wrist may be used to make a cushion within the joint or to create a suspension effect that stabilizes the thumb base.