New Technologies in the Treatment of Base of Thumb Osteoarthritis.

J Am Acad Orthop Surg · Oct 01 2024 · Review

Rotem G, Kadar A

From the Division of Orthopedic Surgery, University of Western Ontario, Roth-McFarlane Hand and Upper Limb Center,…

Hand & Upper Extremity

SUMMARY — THE REDUCTIONThis review surveys emerging technologies for thumb CMC osteoarthritis—including 3D-printed braces, ultrasound-guided fat injections, new implant arthroplasty designs, and patient-specific instrumentation—noting none yet proven superior to standard care.
Abstract, as published

Symptomatic osteoarthritis (OA) of the first carpometacarpal (CMC) joint is prevalent and debilitating, commonly affecting the elderly and postmenopausal population. This review highlights the latest advancements in the treatment of thumb CMC OA, which historically includes a range of nonsurgical and surgical options without a consensus benchmark. We will focus on innovative and emerging technologies. Nonsurgical treatments typically comprise custom braces and corticosteroid injections. In addition, this review explores advanced approaches such as 3D printed braces, which have improved patient satisfaction, and novel intra-articular injectables such as autologous fat, optimized by ultrasonography to enhance treatment precision and outcomes. Although standard surgical treatments include trapeziectomy, with or without ligament reconstruction and tendon interposition, more recent implant arthroplasty designs show promising long-term survival. Newer interventions include patient-specific instrumentation for metacarpal osteotomies, selective joint denervation, and innovative suspensionplasty devices, all marked by their increased precision and personalized care. However, it is important to note that these novel technologies are not yet established as superior to standard treatments of thumb CMC OA.

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