Thumb Base Joint Replacement
Thumb base joint replacement is an innovative, safe, and effective surgical procedure that replaces an arthritic joint at the base of the thumb with an artificial ball and socket joint. It can reduce pain and help you regain thumb strength and mobility.
At a glance
- Doctor referral only
- Consultation required
- Paediatric Patients Aged 12-18 Seen
- Health insurance
- Self-Pay Available
What is thumb base joint replacement?
Thumb base joint replacement is a surgical procedure used to treat advanced arthritis at the base of the thumb when non-surgical options (such as splints, hand therapy, steroid injections, or pain relief medication) are no longer effective.
At Welbeck, we use an innovative and highly effective technique that replaces the worn joint with an artificial ball-and-socket implant. Unlike older surgical approaches that mainly aim to reduce pain by limiting movement, this replacement restores natural joint function and mobility.
The operation is most often performed for people with osteoarthritis of the trapeziometacarpal (TM) joint — the joint where the base of the thumb meets the wrist. As the joint surface wears down over time, it can cause persistent pain, stiffness, and a reduction in grip and pinch strength. Thumb base arthritis is especially common in women over 50, although it can also develop earlier in life.
At Welbeck, our consultant orthopaedic surgeons are specialists in hand and wrist surgery and provide this advanced treatment within our state-of-the-art Surgery Centre. With integrated access to imaging, surgery, and physiotherapy, we’ll help you to regain thumb strength, movement, and comfort as quickly and safely as possible.
Paediatrics
We offer appointments to paediatric patients aged 12 to 18. For full information on our paediatrics service, please visit our main Paediatrics page.
More information
On the day of your procedure, your consultant and anaesthetist will review your medical history and answer any last questions you have. When you’re ready, your anaesthetist will administer either a general anaesthetic (so you’ll be asleep) or a local anaesthetic (which numbs the arm while you remain awake, or lightly sedated). Throughout your procedure, our team will monitor you closely to ensure you’re safe and comfortable.
During the procedure:
Your surgeon will make an incision at the base of the thumb.
A small amount of the thumb metacarpal base will be removed.
The artificial joint will be implanted.
The incision will be closed with stitches.
Thumb base replacement typically takes around 1 hour. After your surgery, you’ll be able to relax and recover in private, comfortable surroundings, supported by our specialist nursing team, and you can go home the same day.
Thumb base replacement is a very safe procedure, but as with all surgery, there are some associated risks.
Risks include:
bleeding or infection at the incision site
continued pain, swelling, or stiffness in the thumb despite the surgery
loosening or wear of the implant over time
reduced pinch strength or thumb shortening compared with non-implant surgeries
nerve irritation
dislocation
Following thumb base joint replacement, there’s a possibility that further surgery may be needed in the future. This could involve replacing the existing implant or carrying out an alternative procedure known as a trapeziectomy, where the trapezium bone in the affected joint is removed.
Thumb base replacement is a relatively new procedure compared with larger joint replacements, such as hip surgery, so long-term data is still developing. However, current research shows that around 85% of implants remain in place and functioning well 8 to 10 years after surgery.
Your consultant will monitor your recovery and long-term results at follow-up appointments to ensure your implant continues to perform well.
Your consultant will explain exactly how to prepare, including any fasting requirements — this usually means not eating or drinking for 6 hours before surgery. It’s also important to let your consultant know about any medications you take, including over-the-counter pain relief such as paracetamol or aspirin. You’ll also need to arrange for someone to collect you after your operation.
After your surgery, your thumb will be immobilised initially in a cast, and you’ll be given a sling to wear. After a short period, you’ll be able to transition to wearing a splint, which you’ll wear until 6 weeks after your operation.
Swelling and discomfort in the thumb and hand are normal in the first few weeks. Elevating the hand, gentle exercises for the wrist and fingers (to maintain motion) and following any hand-therapy guidance you’re given can help. You’ll be able to resume light activities relatively soon after surgery, but it will take a few months to regain full strength and range of motion in your thumb.
Please contact the Surgery Centre for pricing.
At Welbeck, our orthopaedic surgeons are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
To book a thumb base joint replacement, you must be referred by either your GP or an orthopaedic surgeon following a consultation with them. Self-referrals are not accepted for this treatment.
If you would like to schedule a consultation with an orthopaedic surgeon, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
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Frequently asked questions
Not always. The aim is to restore good function and relieve pain, but slight differences in thumb shape, length, or alignment may remain compared with the untreated thumb. Some patients notice mild thumb shortening or a change in appearance, though for most, this does not affect function. Your surgeon will explain expected cosmetic and functional outcomes in your individual case.
Yes, in most cases. Part of your rehabilitation plan will include hand therapy to restore fine motor control, grip and pinch strength. The timing of returning to such hobbies depends on healing, but many patients resume lighter or moderate instruments after a few months, and full use returns after 6 months or longer. Your physiotherapist will guide you safely back into these activities.
You may still be suitable for thumb base joint replacement, but your consultant will carefully consider your type of work, bone quality, joint stability, and the expected lifespan of the implant before recommending it. While this surgery can successfully restore movement and reduce pain, heavy or repetitive pinching and gripping can place extra stress on the implant and may reduce how long it lasts. In some cases, your surgeon might suggest an alternative operation that’s better suited to your work demands.
There isn’t a specific age that’s considered ideal — suitability depends more on the severity of arthritis, pain levels, and how much your thumb function is affected, rather than age alone. Most people who benefit from thumb base joint replacement are in their 50s or 60s, when arthritis symptoms begin to limit everyday activities such as gripping, writing, or opening jars. Younger patients may also be suitable if their arthritis is advanced and non-surgical treatments are no longer effective. Your consultant will assess your overall health, activity level, and the demands you place on your hands to decide if it’s the right time for surgery.