Base of Thumb OA
Definition
Degenerative arthritis at trapeziometacarpal joint (CMC)
- trapezoid - metacarpal
Epidemiology
Commonest hand joint involved in OA
Most common in older women
Degenerative arthritis at trapeziometacarpal joint (CMC)
- trapezoid - metacarpal
Commonest hand joint involved in OA
Most common in older women
Post-traumatic (type III clavicle fractures)
Idiopathic
1. OA with osteophytes
- contribute to impingement
2. Osteolysis with resorption & gross osteoporosis
Male & Females > 60 years
- X-ray evidence of OA
Symptomatic
- 25% females
- 15% males
Base thumb
PIPJ / Bouchard's nodes
DIPJ / Heberden's nodes
Relatively rare
Average age 50
Men 4:1 Women
Usually dominant arm
Primary
- associated with strenuous manual labour
Secondary
- trauma
- OCD
- synovial chondromatosis
- valgus extension overload / MCL insufficiency
1 in 10 patients with symptomatic knees have isolated PFJ OA
Obesity
Repetitive deep flexion
Malalignment
Lateral patella tightness
Blunt trauma
Anterior knee pain
- rising from chair
No accepted definition
Chronic joint disorder in which there is progressive softening and disintegration of articular cartilage
- accompanied by new growth of cartilage and bone at the joint margins
- these changes secondary to mechanical failure of hyaline cartilage
Essentially no inflammatory component
Primary
Idiopathic
A. Ankle Fracture
Types
- Weber A 4%
- Weber C 33%
- Displaced large posterior malleolar
Any OA develops in first 2 years
Causes
- articular damage at time of injury
- non anatomical reconstruction
- complications i.e. infection