Table of ContentsView AllTable of ContentsWhat Is a Trapeziectomy?PurposeHow to PrepareWhat to ExpectRecoveryLong-Term Care

Table of ContentsView All

View All

Table of Contents

What Is a Trapeziectomy?

Purpose

How to Prepare

What to Expect

Recovery

Long-Term Care

Atrapeziectomyis a surgical procedure in which thetrapezium, one of the bones of the wrist, is removed to treat symptoms ofthumb arthritis. Most people experience an improvement in their arthritis symptoms after a trapeziectomy, including decreased pain and improved use of their thumb for gripping, pinching, and grasping.

This article explains what is involved in a trapeziectomy, including when it is needed, how to prepare, and what to expect during and after surgery.

Marina Khromova / Getty Images

A male massage therapist puts pressure on a sensitive point on a woman’s hand.

A trapeziectomy is a surgery used to treattrapeziometacarpal osteoarthritis, also known as thumb arthritis.Osteoarthritisis the most common form of arthritis associated with the aging-related degeneration of joints.

During a trapeziectomy, the trapezium bone is removed and the space is filled with a tendon graft or an implant made from silicone or metal. The trapezium is a nugget-shaped bone in the wrist situated immediately beneath the long bone of the thumb, called themetacarpal bone.

Because the thumb is a very mobile joint, it lacks the stability to withstand repetitive stress and wears down easily over time. When this happens, thecartilagein the joint between the trapezium and metacarpal bones will break down and thin. Over time, the underlying bone will start to change and the joint space will narrow, causing pain, stiffness, and swelling.

When these symptoms do not resolve with conservative treatments, a trapeziectomy may be recommended. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) is one of the most common procedures for treating thumb arthritis.

Location of trapezium bone.SEBASTIAN KAULITZKI / SCIENCE PHOTO LIBRARY / Getty Images

X-ray highlights the trapezium bone, which is part of the wrist at the base of the thumb.

SEBASTIAN KAULITZKI / SCIENCE PHOTO LIBRARY / Getty Images

Potential Risks

Most people recover well after a trapeziectomy, but there are potential risks associated with the surgery, including:

Speak with your healthcare provider to fully understand the benefits and risks of a trapeziectomy to determine if it is the best treatment option for you.

Purpose of a Trapeziectomy

The primary reason to undergo trapeziectomy is to resolve arthritis pain at the base of the thumb that gets worse with movement or activity.

A trapeziectomy is commonly performed when thumb arthritis does not improve with conservative treatments, including:

Treatments for Arthritis of the Thumb

A trapeziectomy is often performed as anoutpatient procedure, meaning you’ll go home the same day. You won’t be allowed to drive home after surgery, so be sure to arrange for a ride.

You may also need to take a break from certain drugs or supplements you take several days before surgery as they may promote bleeding or interfere with anesthesia. These include:

You will also be instructed to stop eating before midnight on the eve of your surgery. This is to avoid possible vomiting and accidentalaspirationwhile undergoing anesthesia.

Be sure to follow your surgeon’s pre-operative instructions to avoid complications or the possible delay of your procedure.

Procedures can vary depending on where your trapeziectomy is performed. The information below gives you a general idea of what to expect.

Before the Surgery

When you arrive for your surgery, you will be taken to a pre-op room where you will:

You’ll then be wheeled on a gurney to the operating table.

During the Surgery

Depending on the severity of your arthritis and other factors, you may undergogeneral anesthesia(in which you are fully asleep),monitored anesthesia care(“twilight sleep”), orlocal anesthesia(which numbs the surgical site while you remain awake).

Trapeziectomy involves multiple steps. For a trapeziectomy with LRTI, the surgeon will typically:

It usually takes 60 to 90 minutes to complete a trapeziectomy.

After the Surgery

After your trapeziectomy, you will be brought to a recovery room. Your vital signs will be monitored as the effects of the anesthesia begin to wear off. You’ll typically be able to go home one or two hours after the procedure.

The approximate cost of a trapeziectomy before insurance is $4,500.It may be higher or lower depending on where you live and what facility you use.

After a trapeziectomy, you’ll go home with stitches and a cast on your thumb. To help ease pain and inflammation, you’ll be prescribed medication likeTylenol (acetaminophen). You can alsoice and elevateyour hand, especially during the first week.

A typical recovery timeline looks like this:

Your surgeon will give you specific instructions on how tochange dressingsand wash the incision site once your cast is removed. Do not use lotions, creams, or ointments on the area unless your provider gives you the OK.

A trapeziectomy has a high success rate. Additional surgeries are uncommon.

With that said, it may take time before you can regain full use of your thumb and hand. To ensure the best possible outcome, follow these simple, self-care instructions:

Summary

A trapeziectomy is a surgery used to treat thumb arthritis when conservative treatments fail. It involves removing a bone in the wrist, called the trapezium, and replacing it either with a tendon from your own body or a metal or silicone implant.

Recovery times can vary from several weeks to several months. It is crucial that you follow your healthcare provider’s instructions to ensure the best possible results.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kawamura D, Funakoshi T, Iwasaki N.Trapeziectomy with ligament reconstruction and interposition arthroplasty using the palmaris longus tendon: An average 5-year follow-up.Clin Orthop Surg. 2019 Dec;11(4):453-458. doi:10.4055/cios.2019.11.4.453Arthritis Care.Trapeziectomy.British Columbia Department of Health.Warfarin therapy - management during invasive procedures and surgery.Aroke EN, Robinson AN, Wilbanks BA.Perioperative considerations for patients with major depressive disorder undergoing surgery.J Perianesth Nurs.2020 Apr;35(2):112–9. doi:10.1016/j.jopan.2019.08.011Epstein NE.When to stop anticoagulation, anti-platelet aggregates, and non-steroidal anti-inflammatories (NSAIDs) prior to spine surgery.Surg Neurol Intl.2019 Mar;10:45.National Health Service (UK).Trapeziectomy.Elfar, JC, Burton, RI.Ligament reconstruction and tendon interposition for thumb basal arthritis.Hand Clin. 2013;29(1):15-25. doi:10.1016/j.hcl.2012.08.018Jain A, Herrera FA.Cost analysis and national trends in the treatment of thumb basal arthritis: comparing ligament reconstruction/tendon interposition and trapeziectomy/hematoma distraction arthroplasty.Ann Plast Surg. 2021;86(6S Suppl 5):S622-S624. doi:10.1097/SAP.0000000000002789

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kawamura D, Funakoshi T, Iwasaki N.Trapeziectomy with ligament reconstruction and interposition arthroplasty using the palmaris longus tendon: An average 5-year follow-up.Clin Orthop Surg. 2019 Dec;11(4):453-458. doi:10.4055/cios.2019.11.4.453Arthritis Care.Trapeziectomy.British Columbia Department of Health.Warfarin therapy - management during invasive procedures and surgery.Aroke EN, Robinson AN, Wilbanks BA.Perioperative considerations for patients with major depressive disorder undergoing surgery.J Perianesth Nurs.2020 Apr;35(2):112–9. doi:10.1016/j.jopan.2019.08.011Epstein NE.When to stop anticoagulation, anti-platelet aggregates, and non-steroidal anti-inflammatories (NSAIDs) prior to spine surgery.Surg Neurol Intl.2019 Mar;10:45.National Health Service (UK).Trapeziectomy.Elfar, JC, Burton, RI.Ligament reconstruction and tendon interposition for thumb basal arthritis.Hand Clin. 2013;29(1):15-25. doi:10.1016/j.hcl.2012.08.018Jain A, Herrera FA.Cost analysis and national trends in the treatment of thumb basal arthritis: comparing ligament reconstruction/tendon interposition and trapeziectomy/hematoma distraction arthroplasty.Ann Plast Surg. 2021;86(6S Suppl 5):S622-S624. doi:10.1097/SAP.0000000000002789

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kawamura D, Funakoshi T, Iwasaki N.Trapeziectomy with ligament reconstruction and interposition arthroplasty using the palmaris longus tendon: An average 5-year follow-up.Clin Orthop Surg. 2019 Dec;11(4):453-458. doi:10.4055/cios.2019.11.4.453Arthritis Care.Trapeziectomy.British Columbia Department of Health.Warfarin therapy - management during invasive procedures and surgery.Aroke EN, Robinson AN, Wilbanks BA.Perioperative considerations for patients with major depressive disorder undergoing surgery.J Perianesth Nurs.2020 Apr;35(2):112–9. doi:10.1016/j.jopan.2019.08.011Epstein NE.When to stop anticoagulation, anti-platelet aggregates, and non-steroidal anti-inflammatories (NSAIDs) prior to spine surgery.Surg Neurol Intl.2019 Mar;10:45.National Health Service (UK).Trapeziectomy.Elfar, JC, Burton, RI.Ligament reconstruction and tendon interposition for thumb basal arthritis.Hand Clin. 2013;29(1):15-25. doi:10.1016/j.hcl.2012.08.018Jain A, Herrera FA.Cost analysis and national trends in the treatment of thumb basal arthritis: comparing ligament reconstruction/tendon interposition and trapeziectomy/hematoma distraction arthroplasty.Ann Plast Surg. 2021;86(6S Suppl 5):S622-S624. doi:10.1097/SAP.0000000000002789

Kawamura D, Funakoshi T, Iwasaki N.Trapeziectomy with ligament reconstruction and interposition arthroplasty using the palmaris longus tendon: An average 5-year follow-up.Clin Orthop Surg. 2019 Dec;11(4):453-458. doi:10.4055/cios.2019.11.4.453

Arthritis Care.Trapeziectomy.

British Columbia Department of Health.Warfarin therapy - management during invasive procedures and surgery.

Aroke EN, Robinson AN, Wilbanks BA.Perioperative considerations for patients with major depressive disorder undergoing surgery.J Perianesth Nurs.2020 Apr;35(2):112–9. doi:10.1016/j.jopan.2019.08.011

Epstein NE.When to stop anticoagulation, anti-platelet aggregates, and non-steroidal anti-inflammatories (NSAIDs) prior to spine surgery.Surg Neurol Intl.2019 Mar;10:45.

National Health Service (UK).Trapeziectomy.

Elfar, JC, Burton, RI.Ligament reconstruction and tendon interposition for thumb basal arthritis.Hand Clin. 2013;29(1):15-25. doi:10.1016/j.hcl.2012.08.018

Jain A, Herrera FA.Cost analysis and national trends in the treatment of thumb basal arthritis: comparing ligament reconstruction/tendon interposition and trapeziectomy/hematoma distraction arthroplasty.Ann Plast Surg. 2021;86(6S Suppl 5):S622-S624. doi:10.1097/SAP.0000000000002789

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