Trapeziectomy for Thumb Arthritis

A well-established surgical treatment for thumb base arthritis.

Trapeziectomy is one of the most commonly performed operations for thumb base (CMC) arthritis. It involves removing the arthritic trapezium bone at the base of the thumb to relieve pain and improve hand function.

While many patients are successfully treated with trapeziectomy, modern alternatives such as thumb joint replacement may also be appropriate for selected patients. The most suitable procedure depends on your age, activity level, arthritis pattern and individual goals.

What is a Trapeziectomy?

The trapezium is a small bone at the base of the thumb that forms the thumb carpometacarpal (CMC) joint.

When arthritis develops, the joint surfaces become worn, causing pain, weakness and difficulty gripping.

A trapeziectomy removes the trapezium bone, eliminating the painful arthritic joint.

Various techniques may then be used to stabilise the thumb, including:

  • Simple trapeziectomy

  • Trapeziectomy with ligament reconstruction

  • Tendon interposition (LRTI)

  • Suspension techniques

The most appropriate technique depends on the individual patient and surgeon preference.

When is Trapeziectomy Recommended?

Trapeziectomy may be considered when:

  • Thumb base pain persists despite non-surgical treatment

  • Activities such as opening jars or turning keys become difficult

  • Splints and injections no longer provide adequate relief

  • Arthritis significantly affects daily activities

Most patients have already tried physiotherapy, splinting and corticosteroid injections before considering surgery.

The Procedure

Trapeziectomy is performed through an incision over the base of the thumb.

The arthritic trapezium bone is removed, relieving the painful bone-on-bone contact within the joint.

Depending on the surgical technique, the thumb may then be stabilised using surrounding ligaments or a tendon graft.

The operation is usually performed as day surgery under general anaesthesia with or without a regional block.

Recovery After Trapeziectomy

Recovery occurs gradually over several months.

Most patients can expect:

  • A splint following surgery

  • Early hand therapy

  • Gradual restoration of movement

  • Progressive strengthening

  • Improvement in pain over several months

Full recovery commonly takes 3–6 months, although strength may continue to improve for up to a year.

Trapeziectomy or Thumb Joint Replacement?

Both procedures aim to relieve pain caused by thumb base arthritis.

Trapeziectomy has an excellent long-term track record and remains an appropriate option for many patients.

Thumb joint replacement is a newer motion-preserving procedure that may provide faster recovery and more natural thumb movement for appropriately selected patients.

The best operation depends on several factors, including:

  • Age

  • Activity level

  • Occupation

  • Joint stability

  • Bone quality

  • Personal goals and expectations

Mr Francis Ting offers both trapeziectomy and thumb joint replacement and will discuss the advantages and disadvantages of each procedure during your consultation.

Learn more about Thumb Joint Replacement →

Frequently Asked Questions

Is trapeziectomy still a good operation?

Yes. Trapeziectomy remains one of the most reliable operations for thumb base arthritis and has excellent long-term results.

Will I lose thumb movement?

Most patients retain useful thumb movement while experiencing significant pain relief. Some shortening of the thumb may occur.

How long does recovery take?

Most patients return to light activities within several weeks, although strength and full recovery continue to improve over several months.

Related Conditions

Why Choose Peak Orthopaedics?

Mr Francis Ting is a fellowship-trained orthopaedic surgeon specialising in hand and upper limb surgery.

Treatment is individualised to each patient. Whether the most appropriate option is trapeziectomy, thumb joint replacement or continued non-surgical management, the aim is always to relieve pain, restore function and help patients return to the activities that matter most.