Osteoarthritis of the thumb carpometacarpal joint has a reported radiographic prevalence of 7 percent in men and 15 percent in women. Many patients remain minimally symptomatic; however, a subset of patients develop debilitating pain, weakness, and instability that severely limit hand function. Treatment options have focused on removal of the diseased trapezium and stabilization of the metacarpal base. Newer options, including carpometacarpal arthroplasty, may have a role in some patients for improving function. This article explores the anatomy and biomechanics of carpometacarpal arthritis and its present surgical treatment options.
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