What is osteoarthritis?

Osteoarthritis commonly affects the basal joint of the thumb and interphalangeal joints of the fingers. As we age, our joint surfaces degenerate and can cause pain, joint deformity and limitation in our daily lives and activities.

What is osteoarthritis surgery?

When osteoarthritic pain is severe and oral analgesics are no longer effective, surgery is a recommended next option for relief. The surgery depends on the joint involved and the severity of osteoarthritis. This can include fusion of the joint, joint replacement or bone removal and ligament reconstruction of the thumb.

Who does this procedure suit?

This procedure is for those that have had a diagnosis of osteoarthritis and are seeking a more permanent pain relief.

What results will I expect?

Surgery for arthritis is highly effective and can often provide permanent relief to pain and restoration of the function of the hand, fingers and thumb. Most patients experience immediate improvement in their symptoms although this varies between patients. In the vast majority of patients, results are often life-long however very occasionally some patients may having recurring symptoms a few years after surgery.

What’s the first step to take?

During your first consultation your surgeon will discuss what you’d like to achieve, any expectations you have, questions about the procedure, medical history and current medication. Your surgeon will often arrange for x-rays to be performed to confirm the diagnosis prior to surgery. We will provide as much information as possible so that you feel comfortable and informed.

How do I prepare for surgery?

Please ensure you have arranged someone to drive you home after your surgery and to help you out at home for a few days. To reduce risk of bleeding and bruising please make sure to:

• Avoid pain relievers and Vitamin E two weeks before surgery. Panadol, and vitamins B and C are safe to use.
• Inform your surgeon if you take any herbal medicines that may affect clotting and the anesthetic.
• Avoid smoking before and after surgery so as not to restrict circulation to the area and delay healing. Giving up altogether is best.
• Inform us immediately if you’ve had any infection (cold or flu) the week before your surgery.

What happens on the day of my surgery?

We will guide you to prepare for surgery so that your procedure and recovery go smoothly.

• If your procedure is in the morning – do not eat or drink anything after midnight the night before.
• If your procedure is in the afternoon – do not eat or drink anything after 8.00am.

What should I expect during surgery?

Osteoarthritis surgery is performed under general anesthetic or a light sedation with local anesthetic. Whichever you choose, you will be very comfortable and experience no pain during the surgery.

Options for procedures include:

• Joint arthrodesis (fusion of the joint)
• Joint replacement
• Trapeziectomy (removal of the bone and ligament reconstruction – for thumb basal joint arthritis)
• After the procedure any incisions are sutured and dressings applied. This procedure takes approximately 30-60 minutes and you will be able to go home a few hours after.

What should I expect after surgery?

• Your hand will be in a bulky bandage with a splint to protect the area. You will also be given a sling to wear at home. You may notice some bruising which will fade in 4-5 days.
• Local anesthetic is used at the end of the procedure so that you have pain relief for the following 6-8 hours.
• Some discomfort is normal for the first few days, which is easily relieved with oral analgesics and/or antibiotics. Keeping the hand elevated in a sling for 2 days will also help settle the pain.
• A follow up appointment will be made 7-10 days after to assess that the wound has healed well and to remove any sutures. If necessary, we will refer you to see our hand therapist for any recovery needed.
• After 2 weeks your hand can be used for light duties and return to heavier activities after 4-6 weeks. Your surgeon or hand therapist will guide you.

What are the risks and complications with this procedure?

As with any surgery there are some risks involved such as:

• Infection, excessive bleeding or bruising
• Nerve injury (less than 1%)
• Wrist pain/ache (5-10% of patients and it settles in a few months)

Please call our office if you experience any of the following: excessive pain or bleeding, abnormal swelling or fever during the first 24 hours.