Newest advances in the operative treatment of basal joint arthritis.

Osteoarthritis of the basal joint of the thumb is common, particularly in postmenopausal females, and can cause considerable pain and disability. Incompetence of the volar beak ligament is thought to be the inciting event that eventually leads to joint degeneration in a predictable pattern. The clinical history and examination can reliably lead to the diagnosis. Radiographs are used to stage the severity of the arthritis. Conservative treatment can be effective in early disease. Operative treatment has been shown to be successful in relieving pain and restoring thumb function in advanced disease. The majority of reconstructive procedures include partial or complete trapeziectomy with beak ligament reconstruction and tendon interposition. Secondary metacarpophalangeal joint hyperextension and associated carpal tunnel syndrome must be diagnosed and addressed to prevent poor outcomes.