The TOUCH® CMC 1 prosthesis is an innovative approach to arthritis at the base of the thumb. Previous treatments focused on the removal of the entire arthritic bone in the wrist. This procedure is a complete joint replacement of the thumb CMC joint which preserves the normal bony architecture while replacing the contact surfaces of the joint.

The implant works very similarly to a total hip replacement, but is applied to the thumb. The arthritic surfaces of the wrist and thumb bones are removed and are replaced with a new ball and socket joint. The new prosthesis now bears the force instead of the worn out joint. This often results in less pain and increased range of motion with activity.

The previous gold standard procedure for basilar thumb arthritis involved the removal of the entire arthritic trapezium in the wrist. The base of the thumb was then suspended with a synthetic sling or a ligament. With time, this often results in the base of the thumb collapsing into the palm into a position called adduction. This can result in a loss of strength, range of motion, and lead to revision procedures. Because this new technique is a total joint replacement, the anatomy is preserved. This limits the migration and displacement of the thumb that can occur. With the thumb in a more anatomic position, the function can theoretically be restored closer to a patient’s baseline level of activity.

The TOUCH® CMC 1 prosthesis is an excellent option for patients experiencing pain secondary to arthritis at the base of the thumb. Like all surgeries, this technique is simply a tool to address a certain situation. There are still situations where traditional management (trapeziectomy with or without suspensionplasty) is known to be superior. This is why it is important to consult with an experienced and well trained surgeon to discuss your unique situation. If you are a candidate for this procedure, it does seem to have a significantly shorter, and less painful recovery, with less need for bracing and rehabilitation. It may also be a superior option for patients that have previously been too young for traditional surgical techniques.

While you will need to consult with your specific surgeon, this procedure is best indicated for those with isolated osteoarthritis (wear and tear arthritis) of the base of the thumb. Traditional trapeziectomy with suspensionplasty can collapse with time as the suspensory sling wears out. Because of this, it is usually avoided in younger patients as they will likely outlive the surgical repair resulting in a collapse of the thumb. With the ability to replace the components, essentially repeating the surgery after it has worn out, as well as the ability to easily convert this to a traditional trapeziectomy, the TOUCH® CMC 1 prosthesis is now viewed as a viable treatment for younger patients. Additionally, those who require complex dexterity of the thumb, such as musicians, etc. will see benefits to the more anatomical position and function of the thumb.

Currently Dr. Alan Swenson is the only surgeon in the state of Alaska who is certified and trained to perform this surgery. For more information, please schedule a consultation to discuss your individual case. We look forward to seeing you.