Thumb Arthritis

None — Osteoarthritis of the Thumb

The ends of the bones in a joint are protected with a covering called cartilage, which prevents the bones from rubbing together during movement. Osteoarthritis is a condition in which the cartilage in a joint begins to break down or wear away. This allows some areas of bone to rub during joint movement.

Osteoarthritis is the most common form of arthritis. According to the Arthritis Foundation, the condition affects 27 million Americans. Symptoms typically first appear after 40. One of the most commonly affected joints is the carpometacarpophalangeal (CMC) joint, located at the base of the thumb. This joint is important for pinching and gripping. When osteoarthritis occurs in this joint, a patient may have pain, swelling and stiffness at the base of the thumb. Range of motion, grasping and pinching strength may be decreased as well. Some patients also develop a bony bump at the base of the joint.

Treating Thumb Osteoarthritis

There is a wide range of treatments available for osteoarthritis of the thumb. Ice packs and anti-inflammatory pain medication may be recommended to reduce pain, swelling and inflammation. A splint may be used to temporarily limit range of motion and allow the joint to rest and heal. For more severe symptoms, a doctor may inject steroid medication into the joint. The medication reduces inflammation, but the effects wear off, usually after a few months.

Steroids don't stop progression of the arthritis and the symptoms may eventually become more severe. In those cases, surgery may be needed. In joint fusion, the bones are permanently fused together to form one solid bone. The procedure reduces pain. However, the fused joint can no longer bend, so mobility is limited. Another option is joint replacement, removal of the diseased joint and replacement with an artificial joint.

Hyaluronan for Thumb Osteoarthritis

Researchers at The Hospital for Special Surgery in New York City are testing another treatment for osteoarthritis of the joint at the base of the thumb, using an injection of hyaluronan (Synvisc-One®, or hylan G-F 20). Hyaluronan is a laboratory-made form of a protein produced by the body and found in the joints. The drug is currently used to reduce pain and improve function in people with osteoarthritis of the knee.

Participants in the study will be randomly assigned to one of three treatments: (1) two injections of hyaluronan, (2) one injection of a steroid and one injection of a local anesthetic, or (3) two injections of a local anesthetic.

In each group, the second injection is given one week after the first. At the end of the study, all the participants will have the option to receive an injection of hyaluronan.

A previous study done outside the U.S. showed patients who received hyaluronan injections had significant improvements in function, pain and pinch strength at 24 weeks compared to those who received saline injections. Now researchers here in the U.S. want to find out how injections of hyaluronan compare to other steroids and local anesthetics.

Investigators are still looking for participants. The study is only taking place at The Hospital for Special Surgery in New York.

For information about the study, click here, then type the trial identification number in the search box: NCT00398866.

For information on thumb arthritis:

American Academy of Orthopaedic Surgeons American Society for Surgery of the Hand Arthritis Foundation Centers for Disease Control and Prevention

WSOC