New hope for arthritis sufferers as first thumb joint replacement surgery in Fife

Orthopaedic specialists at Queen Margaret Hospital in Dunfermline recently carried out the region’s first thumb joint replacement surgery. It offers a new option for patients whose symptoms have not improved with non-surgical treatments. The procedure has already been performed on several patients, with further cases planned.

Thumb arthritis – also known as base of thumb or carpometacarpal (CMC) joint arthritis – affects the joint where the thumb meets the wrist. As cartilage wears away, the joint becomes painful, stiff and weak, making everyday activities such as opening jars, turning keys or fastening buttons increasingly difficult.

Treatment usually begins with non-surgical options such as pain relief, splinting, hand therapy and, in some cases, steroid injections. When these measures no longer provide adequate relief, surgery may be considered.

Until now, the most commonly used surgical option has been a procedure known as trapeziectomy, where the diseased bone at the base of the thumb is removed. While effective for many patients, it can involve a prolonged period in a cast and a lengthy recovery, with patients often taking a significant amount of time to regain function and strength in the thumb.

The new base of thumb joint replacement procedure offers an alternative surgical approach. During the operation, the damaged joint surfaces are removed and replaced with an artificial joint - in a similar way to hip or knee replacement surgery. This allows patients to begin mobilising their thumb sooner, with less considerably discomfort during recovery.

The development of the new technique is being led by Simon Harrison, consultant orthopaedic surgeon, who said of the development of the new procedure.

“Base of thumb arthritis can be extremely painful,” he said. “Its effects can be debilitating as it can significantly limit a person’s ability to carry out everyday tasks, particularly activities that involve gripping or pinching.

“While joint replacement surgery will not be suitable for everyone, it offers an additional option for carefully selected patients who continue to struggle despite other treatments. Not only is the procedure proving to be more effective that more traditional techniques, but it also offers less post-operative pain and discomfort for those undergoing the procedure.”

Introducing the procedure locally also means eligible patients can now access specialist assessment and treatment closer to home, supported by NHS Fife’s orthopaedic and hand therapy teams at Queen Margaret Hospital in Dunfermline and the National Treatment Centre in Kirkcaldy.

The new procedure builds on a long track record of surgical innovation at Queen Margaret Hospital, reinforcing its reputation as a national leader in day surgery.

Dr Iain MacLeod, NHS Fife’s deputy medical director, said of the latest development in day surgery: “Queen Margaret Hospital has a long-standing and well-established reputation as a national leader in day surgery. That reputation is built on the careful and evidence-based introduction of new surgical techniques that improve outcomes for patients.

“This new base of thumb joint replacement procedure is a further example of that approach in practice. By adopting innovative surgical techniques that can reduce pain and support faster recovery, our teams are helping more patients return to everyday activities sooner, while continuing to deliver safe, high-quality care close to home.”