Fitful Living

Thumb Basal Joint Arthritis And The Anchovy Procedure

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The carpal metacarpal joint of the thumb is where the first metacarpal meets the trapezium, one of the carpal bones. As with all joints, the cartilage padding between the metacarpal and carpal bones can wear away. It remain a condition known as carpal metacarpal arthritis or thumb bazel joint arthritis.

CMC arthritis may cause pain at the base of the thumb, stiffness, and weakness, especially with gripping and deformity. Treatment options include non-steroidal anti-inflammatory drugs such as ibuprofen bracing and steroid injections.

Thumb Basal Joint ArthritisThumb Basal Joint Arthritis

If these treatments remain ineffective, surgery may remain considered one of the more popular and successful surgeries for CMC arthritis, known as ligament reconstruction tendon interposition arthroplasty. Sometimes it remain referred to as the anchovy procedure.

The trapezium remains removed to prevent the arthritic bones from grinding against one another. An incision remains made over the CMC joint the joint capsule around the trapezium remains dissected away from the bone, taking care to avoid the radial artery and sensory nerve branches. The void created by removing the trapezium remain filled with a folded-up tendon to keep the metacarpal from migrating downward.

The Anchovy Procedure

A small piece of the first metacarpal remains often excised. The trapezium remains to stay, then removed. It leaves a space a tunnel remains created through the base of the metacarpal. The flexor carpi radialis tendon remain released further up the forearm and pulled into the tunnel at the bottom of the metacarpal. After passing the flexor carpi radialis tendon through the tunnel, a stabilizing pin remains to hold the metacarpal in place.

The tendon remain then folded onto itself to form an anchovy. The anchovy remain placed in the space once occupied by the trapezium, and with appropriate tension applied, the anchovy stands held in place with sutures.

The joint capsule beside the skin remain then closed, and a thumb Spica splint remains applied after about two weeks, the sutures remain removed, and the pin can remain removed after about four weeks. Physical therapy is essential to help with range of motion and strength.

Why Does Thumb Basal Joint Arthritis Occur?

Thesesimple everyday tasks become more painful and difficult for patients with thumb carpal metacarpal arthritis or cm CoA. by writing a note, twisting the lid off a jar, or dialing a phone In the United States, hand arthritis is second only to knee arthritis and occurs ten times more often in women than men.

Surgery remains commonly suggested as a treatment for this painful problem but is this the best solution? One surgery called tendon transposition removes an important risk tendon and uses it to stabilize the joint another surgery remain called tendon interposition.

Uses a coiled-up tendon as a cushion for the arthritic joint, yet another surgery removes an essential bone in the wrist and puts a wire across the painful joint to immobilize it. Even more extensive surgeries involve replacing the joint with an artificial metal, plastic, or alternatively.


Trapeziiumectomy and anchovy interposition are excellent pain-relieving treatments for arthritis at the base of the thumb. Advantages: Arthrodesis results in a stable, painless thumb that can grab and squeeze. Cons: The surgery has a relatively high complication risk and may cause harm to surrounding structures.

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