Introduction
Pain at the base of the thumb is one of the most common reasons patients seek hand surgery. This condition is often caused by thumb CMC arthritis, also called basal joint arthritis. When non-surgical treatments fail to ease pain and restore function, a specialized procedure called thumb CMC arthroplasty may be recommended. One of the most advanced methods today uses the MicroLink™ Suture Button (ConMed) to stabilize the thumb and preserve strength.
This procedure, also known as suspensionplasty, removes the arthritic trapezium bone and secures the thumb’s metacarpal bone with a permanent suture button system rather than older tendon transfer techniques. Patients in Dawsonville, Duluth, and Braselton often choose this option to relieve pain, restore grip, and return to everyday activities.
Understanding the Thumb CMC Joint
The CMC joint (carpometacarpal joint) is located at the base of the thumb, where the trapezium bone in the wrist meets the thumb metacarpal. This joint allows the thumb to move in multiple directions—grasping, pinching, and rotating—making it essential for daily hand use.
Over time, the cartilage that cushions this joint can wear away, leading to thumb arthritis. Without cartilage, bone rubs directly on bone, causing pain, stiffness, swelling, and loss of motion. This problem is especially common in women over 40, people with physically demanding jobs, and patients with a family history of arthritis.
What Is Thumb CMC Arthritis?
Thumb arthritis develops when the protective cartilage at the thumb joint breaks down. Patients often notice aching or sharp pain at the base of the thumb, especially when pinching or gripping objects.
Other symptoms may include:
- Weakness when opening jars or turning keys
- Swelling and tenderness around the joint
- Stiffness and loss of range of motion
- A visible bump near the thumb due to joint changes
Conservative treatments such as splinting, anti-inflammatory medications, and injections may provide temporary relief. However, when these other treatments no longer control symptoms, joint replacement surgery may be recommended.
What Is Thumb CMC Arthroplasty with Suspensionplasty?
Thumb arthroplasty is a type of joint replacement surgery designed to relieve pain and restore motion. In this procedure, the surgeon removes the damaged trapezium bone to eliminate painful bone-on-bone contact.
The next step is suspensionplasty, which stabilizes the thumb metacarpal after the trapezium is removed. Traditionally, this required a tendon interposition or tendon graft, but newer methods avoid tendon harvesting by using a specialized implant.
The MicroLink™ Suture Button (ConMed)
The MicroLink™ Suture Button is an artificial implant made of durable suture material and two small buttons that hold the thumb in place. The device works like a bridge between the thumb’s metacarpal bone and a nearby bone, usually the scaphoid or index finger metacarpal.
Key advantages include:
- Provides permanent suture fixation without needing tendon grafts
- Preserves soft tissues and avoids donor site morbidity
- Maintains pinch strength and thumb motion
- Durable enough to handle daily stress and gripping
How the Procedure Is Performed
Thumb CMC arthroplasty (suspensionplasty) with MicroLink™ Suture Button is performed on an outpatient basis, meaning most patients go home the same day.
Step-by-step:
- After anesthesia wears off, the surgeon makes a small incision at the base of the thumb.
- The procedure removes the arthritic parts of the joint and the damaged trapezium bone.
- A tunnel is drilled through the thumb metacarpal and an adjacent bone.
- The suture button implant is passed through the tunnels and secured, acting as a stabilizer.
- The implant holds the thumb in its proper position, creating a cushion of scar tissue where the trapezium was removed.
- The incision is closed, and a thumb cast or splint is applied for initial protection.
In some cases, the procedure may use two incisions for optimal placement.
Recovery After Thumb CMC Arthroplasty
Recovery time is gradual, and most patients notice steady improvement over several weeks.
- First few weeks: The hand is protected in a splint or cast to keep the thumb stable. Swelling is managed with rest, elevation, and ice. Pain medications may be used as needed.
- Several weeks later: The splint is replaced with a removable brace, and starting therapy with a hand therapist begins. Gentle motion helps prevent stiffness.
- 6–12 weeks: Patients work on strengthening and restoring grip. Occupational therapy may focus on rebuilding coordination and pinch strength.
- 3–4 months: Most patients return to normal activities, including desk jobs, light household tasks, and gradually heavier activities.
- Full recovery: While light tasks may resume early, patients should avoid lifting heavy objects until cleared by the surgeon.
Risks and Complications
As with any hand surgery, there are risks, though most patients do very well. Possible complications include:
- Infection
- Nerve or blood vessel irritation
- Stiffness or lingering pain
- Implant issues such as loosening or failure
- Need for revision surgery in rare cases
Most patients recover successfully and experience lasting relief from pain.
Everyday Life After Thumb Arthroplasty
Patients often report a dramatic improvement in quality of life once healing is complete. They are able to grasp, pinch, and perform daily activities with less pain.
Whether returning to a desk job or resuming hobbies that require fine hand movements, most patients find their range of motion is preserved. With time and therapy, many regain strong grip and pinching ability, even for physically demanding jobs.
Why Choose Dr. Neustein for Thumb CMC Arthroplasty
Dr. Thomas Neustein is a board-certified orthopedic hand and upper extremity surgeon fellowship-trained at the prestigious Philadelphia Hand to Shoulder Center and Emory University. He specializes in modern solutions for thumb CMC arthritis, including advanced techniques like MicroLink™ Suture Button suspensionplasty.
Patients across North Georgia trust Dr. Neustein for his:
- Expertise in hand surgery and ligament reconstruction
- Access to leading surgical centers with advanced equipment
- Personalized treatment plans tailored to each patient’s needs
- Strong track record of successful outcomes in CMC arthroplasty
Call to Action
If you or a friend or family member are struggling with painful thumb arthritis or loss of hand function, you may be a candidate for thumb CMC arthroplasty with suspensionplasty. Schedule an appointment with Dr. Neustein today to discuss your options and get back to pain-free daily living.
