Published: July 21, 2025
Estimated reading time: 3 minutes
A new procedure for replacing an arthritic joint at the base of your thumb — where it meets your wrist — can provide faster recovery and relief when holding a pen, buttoning a shirt or using hand tools becomes too painful.
Norton Arm & Hand Institute is first in the Louisville and Southern Indiana region to offer the new implant, which removes less bone than conventional thumb joint replacement and shortens recovery time from months to weeks.
Age and injury wear away the cartilage that cushions and protects the ends of the bones that make up the carpometacarpal joint. (,It’s also sometimes called the basal joint or CMC joint). Less cartilage means more bone-to-bone contact and damaged joint surfaces and that means pain and less range of motion.
Early treatment for thumb osteoarthritis includes medication, splinting and physical therapy. Steroid injections into the thumb joint can be very effective at first but will decline over time.
Once nonsurgical options for severe thumb arthritis are exhausted and you’re ready to consider surgery, thumb joint replacement might be something to discuss with your medical provider.
Much like other joint replacements, a thumb joint replacement involves replacing the joint bones. The new surgery, pioneered locally by hand surgeon Antony Hazel, M.D., with Norton Arm & Hand Institute, works similarly, but saves more bone than traditional joint replacements.
Traditional thumb joint replacement has been similar to a total knee or hip replacement —where the ends of the damaged bones are removed and new pieces are secured in place. This has meant complete removal of the trapezium — one of the small bones that make up the wrist joint.
The new thumb surgery, using the BioPro Modular Thumb Implant, burrs out a new socket in the trapezium bone, and the implant is placed in the end of the metacarpal bone (the long thumb bone that meets your wrist). The implant fits neatly into the newly formed socket. Because of the implant’s modular design, your surgeon can choose the precise size to replicate your natural joint. The implant also has shown to be less prone to dislocation, a complication of traditional implant techniques.
Recovery from the surgical procedure typically takes eight to 12 weeks, versus up to a year for traditional thumb replacement. Also, because the trapezium is intact, revision surgery is possible later if necessary.
“For many patients, the prospect of up to a year of recovery time after the hand surgery has been a drawback,” Dr. Hazel said. “This new thumb arthroplasty cuts that to as little as a couple months, with rehab starting after two to four weeks of casting.”
Traditional thumb joint replacement surgery still may be the right approach for some patients and has proven to be effective over the past 40 years. Ligament reconstruction and tendon interposition (LRTI) involves removing all or part of the trapezium and reconstructing your thumb joint with a tendon. The tendon graft is also used to help stabilize the reconstructed thumb joint.
LRTI has a 96% success rate, with most patients achieving complete thumb pain relief and mobility equal to that of a healthy thumb, with results lasting at least 15 to 20 years, according to the Arthritis Foundation.
Other thumb arthritis surgery options include: