Idiopathic Trapeziometacarpal Joint Osteoarthritis: Cause, Prevention and Treatment

Idiopathic osteoarthritis of the trapeziometacarpal (TMC) joint is common. Spontaneous attenuation of either the anterior oblique ligament (Beak ligament) or the dorsoradial ligament has been reported as the cause of the joint laxity, resulting in subsequent wear and tear of the articular cartilages. So far, no cause has been reported for the spontaneous attenuation of these key supporting ligaments of the TMC joint and no effective method of prevention or treatment has been reported for the early stages of the condition. The authors reported a conservative method for the prevention as well as reversal of the early stages of the joint instability before the process of wear and tear sets in and the condition progresses towards osteoarthritis. A retrospective study was performed on 17 patients with early stages of idiopathic TMC joint osteoarthritis. The patients were treated through a conservative management protocol with an average follow-up of 28.4 months. The protocol consisted of performing specifically devised isometric exercises and a functional abduction brace. The result of the conservative treatment was postural correction of the thumb, anatomical stability of the TMC joint and resolution of the symptoms as well as findings including pain, swelling and joint dorsoradial translation. The mean pain score of the patients was 3.6 before the treatment was begun and was zero after the treatment was completed. The presented conservative method is recommended for either prevention or reversal of the early stages of TMC joint instability before the osteoarthritic changes set in.