What Is CMC Arthritis?
The carpometacarpal (CMC) joint sits at the base of the thumb where it meets the wrist. This saddle-shaped joint allows the wide range of thumb motion that makes the human hand unique — but its design also makes it susceptible to arthritis. CMC arthritis occurs when cartilage wears away, causing pain, swelling, and progressive loss of pinch strength.
Symptoms
- Deep, aching pain at the base of the thumb with pinching or gripping
- Swelling and tenderness at the CMC joint
- Weakness — difficulty opening jars, turning keys, or pinching
- A bony prominence at the base of the thumb
- Morning stiffness and a grinding sensation
Non-Surgical Treatment
- Thumb spica splint — supports and rests the CMC joint during activities
- Corticosteroid injections — reduce inflammation; particularly effective in early to moderate stages
- Activity modification and hand therapy
Surgical Treatment — LRTI
When conservative treatment no longer provides adequate relief, surgery offers excellent long-term results. The most common procedure is ligament reconstruction and tendon interposition (LRTI), in which the trapezium bone is removed and a tendon portion is used to reconstruct the joint. Dr. Richards has performed numerous LRTI procedures and brings particular expertise to the nuances of technique that affect outcomes.