Rhizarthrosis surgery is often the last resort of the treatment pathway, when conservative treatments no longer provide relief.

Click on ‘Rhizarthrosis’ for a detailed presentation of this degenerative condition of the joint at the base of the thumb.

A new phase follows surgery (trapeziectomy with ligamentoplasty or trapeziometacarpal [TMC] prosthesis): the recovery phase, which requires careful post-operative monitoring.

Why is post-operative monitoring essential?

The healing process following TMC surgery can take several months. The aims of post-operative monitoring are as follows:

  • to monitor healing and make sure that it is proceeding according to plan;

  • to prevent complications (infection, prosthesis displacement, persistent pain, etc.);

  • to ensure the best possible functional recovery of the thumb.

Monitoring is performed by the hand surgeon, sometimes in conjunction with a physiotherapist, as part of a physiotherapy or self-rehabilitation plan.

Key stages of post-operative monitoring

Recovery depends on the type of operation and the patient’s profile and general health. It usually involves a number of different phases.

1. First few days: immobilisation and monitoring

  • You will be required to wear a post-operative splint to stabilise the thumb. It is very important that you wear it to avoid unwanted movements.

  • Your dressing will be changed regularly by a nurse, to check that your scar is healing and prevent infections.

  • Analgesics, also known as painkillers, will be prescribed as required.

2. From week 3 or 4: gentle mobilisation

Gentle rehabilitation starts, often with specialist support:

  • gradual resumption of joint range of motion;

  • prevention of stiffness;

  • stimulation of the hand muscles.

Practical advice can also be provided in these sessions, in particular regarding adapting everyday hand movements, tasks and activities, especially after bilateral surgery.

3. After 2 to 3 months: partial independence

Simple hand movements, tasks and activities can be resumed. As specified in our page on ‘Recovery time after thumb surgery’, it can take up to 6 months to resume more demanding activities (sport, physical exercise, manual work, etc.).

What are the risks of recurrence or complications?

The aim of surgery is to reduce pain and restore thumb function.

Certain situations can slow down or compromise recovery though.

  • Persistent pain

Pain may persist for weeks or even months, particularly in the event of prolonged oedema or post-operative tension. If pain becomes chronic, it is recommended to seek a new medical opinion.

  • Slow functional recovery

If no rehabilitation or insufficient rehabilitation is performed, it can lead to loss of mobility or strength. Adapted physiotherapy, with personalised support and supervision, is therefore essential.

  • Development of discomfort in other joints

Rhizarthrosis does not recur in the operated area after a trapeziectomy, But discomfort may develop in the tri-scaphoid joint just above (also known as the STT joint), particularly when tilting your wrist. This only occurs in isolated cases, but it is important to know about it.

  • Wear or displacement of the prosthesis

Although mechanical complications can occur with a TMC prosthesis (premature wear, loosening), they are rare because the latest generation of prostheses are more resistant and better tolerated.

The importance of long-term monitoring

Even after the healing phase is over, it is important to:

  • monitor the development of feelings in the thumb, with particular attention paid to any new pain or discomfort;

  • continue to use adapted hand movements, to limit strain on the joints;

  • consult a healthcare professional immediately if in doubt.

Monitoring does not end when the patient leaves the operating theatre, but forms part of a comprehensive treatment plan for rhizarthrosis, in conjunction with other solutions such as braces/splints, injections and natural remedies.

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