What is basal joint arthritis?
Wear and tear of the joint cartilage is a wear and tear of the joint cartilage that occurs insidiously, usually unnoticed at first. Wear and tear of the thumb saddle joint, also known as rhizarthrosis, can be very painful. In most cases, the cause is unknown and targeted therapy is not possible. If the cartilage protective layer is lost, the load is no longer dampened and evenly distributed.
Unfortunately, cartilage damage cannot be completely reversed to date. At the beginning, the forces acting on the joint can be buffered by special thumb splints. Ibuprofen, diclofenac or the vegetable frankincense extract H15 are frequently used because they have an anti-inflammatory and analgesic effect. If these measures no longer help, a surgical intervention can be useful. Which of the various surgical treatments (e.g. fat stem cell treatment, denervation, resection arthroplasty) is the right one for you depends on your requirements and the degree of wear and tear.
Resection arthroplasty is the procedure with the most experience. The worn large polygonal bone is removed via a small access on the outside of the ball of the thumb and the joint is stabilized with suture techniques.
Autologous fat transfer
Fat stem cell transplantation is a new minimally invasive treatment for joint wear. Stem cell therapy can be used as a curative treatment for minor joint degeneration in order to postpone a major intervention such as resection arthroplasty.
The treatment costs are not covered by the health insurance companies. Nevertheless, the positive results of the autologous fat treatment of rhizarthrosis, which has been established since 2014, have been scientifically proven . As a rule, pain relief and functional improvement can be expected for a period of at least 12 months.
The cells can be gently aspirated from the abdomen, thighs, buttocks or knees. The suctioned fat tissue is cleaned and filtered several times. The cells are then injected into the thumb saddle joint. The stem cells from the fat tissue can develop into cartilage cells. In addition, the cells can lead to an improvement of the synovial fluid.
How can you prepare for the procedure?
- All your questions about possible complications and alternative treatments should be answered in advance.
- Keep nicotine and alcohol consumption to a minimum!
- Blood-thinning medication (e.g. ASA, Thomapyrin®) must be at least 10 days before the operation should be discontinued (after consultation with your treating doctor).
- Vitamin preparations (A, E) & food supplements (omega-3 fatty acids, St. John’s wort preparations, etc.) must be min. 4 weeks before the rhizarthrosis operation.
- Surgery limits the ability to travel by air. Therefore, do not plan any professional or private air travel during the 6 weeks after the operation!
- Have ice cubes / cooling pads ready in your own four walls to cool the skin after the thumb saddle joint operation!
How is the procedure performed?
- The outpatient operation is performed under arm or general anaesthesia and lasts about 30 minutes.
What do you need to keep in mind after the procedure?
- Das Hochlagern und Kühlen der Hand in den ersten 72 Stunden ist sehr wichtig.
- Immobilization is recommended for a total of 4 weeks (Palmare forearm wrist thumb splint with free interphalangeal joint in opposition and abduction of the thumb for 14 days; then middle hand thumb splint with release of the interphalangeal joint for a further 14 days).
- Complete fist closure and finger stretching exercises should be performed several times per hour. All joints outside the splint must be fully moved several times an hour.
- A silicone capillary drainage is removed on the 1st postoperative day if necessary, the skin threads are removed after 10 to 14 days.
- Postoperative clinical check-ups are recommended on the 1st and 3rd postoperative day and after 1 and 2 and 4 weeks.
- The independent scar massage from the 3rd postoperative week with moisturizing ointment (e.g. Bepanthen® wound and healing ointment, Linola® fat cream) helps to create inconspicuous soft scars.
- A full load is possible from the 12th postoperative week.
“We provide you with extensive expert knowledge so that we can work with you to select the best possible treatment path.”
Dr. med. Stéphane steel is the former director of the Clinic for Plastic, Reconstructive and Aesthetic Surgery / Hand Surgery at the Lüdenscheid Clinic. Dr. Stahl studied medicine at the Universities of Freiburg and Berlin. In 2011 he passed the European and 2012 the German specialist examination for plastic and aesthetic surgery. Further specialist qualifications and additional qualifications followed (including quality management, medical didactics, physical therapy, emergency medicine, laser protection officers, hand surgery) as well as prizes and awards. In 2015 he completed his habilitation in plastic and aesthetic surgery in Tübingen. He is an experienced microsurgeon, a sought-after expert and a regular speaker at specialist congresses. After a multi-stage selection process, Stéphane Stahl became a member of the American Society for Aesthetic Plastic Surgery (ASAPS), one of the world’s largest and most influential specialist societies for aesthetic surgery. His authorship includes numerous articles in respected peer review journals and standard surgical textbooks.
|↑1.||Herold C, et al. 2014, Handchir Mikrochir Plast Chir; Herold C, et al. 2017, Plast Reconstr Surg; Erne HC, et al. 2018, Plast Reconstr Surg; Haas EM, et al., 2020, Plast Reconstr Surg|