Patients › Hand

Touch thumb arthroplasty

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Updated Aug 2026

A hand-drawn illustration of a hand pinching comfortably between thumb and finger. — X-ray after a Touch thumb arthroplasty: a small dual-mobility implant resurfaces the joint between the trapezium and the thumb metacarpal — the joint that wears out in basal thumb arthritis. Kieran Hirpara 4.0

Why this operation has been suggested¶

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. For degenerative or long-standing problems we usually try non-operative care — activity change, physiotherapy or hand therapy, splinting, and injections — and consider surgery when that has not given enough improvement.

We suggest this procedure to restore function and relieve pain in your thumb base. The surgery replaces the worn joint surfaces to improve grip strength and mobility. Evidence shows that 96% of implants remain in place at 2 years. This high survival rate supports the recommendation for patients with isolated wear-and-tear arthritis in this joint.

Before the operation¶

Please do not eat or drink for seven hours before your surgery. We ask for this extra hour so your procedure can start earlier if the list runs ahead. You must arrange a lift home, as you cannot drive yourself. Wear comfortable clothing that is easy to take off. Bring a current list of all your medications to hospital. We will review your X-rays to plan the operation. If you have other medical conditions, you may need blood tests or a review with the anaesthetist. Most patients do not need these, but we check your health to keep you safe. Please follow your surgeon’s specific advice on any medicines you take.

On the day¶

You present to the hospital’s surgical admissions unit, where you are checked in and prepared for theatre. You meet the anaesthetist to discuss your care. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.

You are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.

What the operation involves¶

Your surgeon makes a single cut over the area being operated on to access the base of your thumb. This approach allows clear visibility of the joint while protecting the nearby nerves and blood vessels. A tourniquet is applied to your arm to keep the surgical field clear of blood.

Inside, your surgeon carefully exposes the joint capsule. The worn-out surfaces of the trapezium bone and the base of your thumb bone are removed. Any bony growths (osteophytes) that could cause pinching or dislocation are also trimmed away. This creates a clean, flat surface for the new implant components.

The base of your thumb bone is shaped to fit the new parts. A small wire is used to guide the placement of a metal cup into the trapezium bone. This cup is secured with spikes to ensure it stays stable and does not rotate. The thumb bone is then prepared to receive the matching component, restoring the natural length and alignment of your thumb.

Once the new joint components are in place, your surgeon checks the movement and stability of the thumb. The cut is then closed using sutures (stitches) alone. A dressing is applied to protect the area as you begin your recovery.

After the operation¶

You will wake up in the recovery ward with your thumb in a protective splint and a soft dressing. Most patients stay one night in hospital after this operation, though some are able to go home the same day. We will manage your pain with standard medication. Please ensure someone stays with you for the first 24 hours to help you rest. You must not drive while wearing the splint, as it stops you gripping the wheel safely. You can drive again once the splint is removed and your surgeon clears you. Keep the dressing clean and dry. Gentle finger movement is encouraged to reduce swelling, but avoid using your thumb for heavy tasks.

Recovery¶

You will notice fast pain relief after your thumb arthroplasty. Your surgeon will guide you through the early days when swelling is normal. We keep your thumb supported in a splint or cast to protect the area. This support helps you rest comfortably while the initial healing takes place. You may need to adjust your sleep position to keep the limb elevated and reduce discomfort.

As the swelling settles, you will begin gentle movements. Your hand therapist, Ruby Doolan at Extend Rehabilitation, directs your exercises and makes any splint you need. We focus on restoring mobility and gradually increasing your grip strength. You will learn how to use your thumb for daily tasks without straining the new joint. Your therapist ensures you progress safely as movement returns.

You cannot drive while wearing the splint, as it stops you from gripping the wheel safely. You may return to driving once the splint is removed and your surgeon clears you. See our guide on driving after upper-limb surgery for more details. Your timeline may differ; your surgeon and therapist will guide you based on your individual recovery.

What can go wrong¶

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

If your thumb implant loosens from the bone, you may feel a deep ache or pain that does not ease with simple painkillers. This is often called aseptic loosening. It can make the joint feel unstable or weak when you grip things. If you notice persistent pain or a change in how your thumb feels, call the clinic for advice.

Sometimes the plastic liner inside the joint can break. You might hear a clicking or grinding sound when you move your thumb. Standard X-rays may look normal, so this can be tricky to spot. If you feel unusual grinding or sudden changes in movement, bring it up at your next review. Your surgeon may need special imaging to check the joint properly.

In some cases, a revision surgery using a different implant type may not be reliable. This is usually considered only if no safer option exists. If your surgeon suggests this path, ask about the risks and what to expect.

The complications table on this page lists typical rates if you want the specifics.

When to call us¶

Call us if you develop a fever, increasing redness or discharge from your wound, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath, or if you lose sensation or cannot move your thumb. We need to check these signs promptly. Please avoid driving while wearing your thumb splint for four to six weeks.

Where to read more¶

This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Basal Thumb Arthritis page.

Where to read more about the condition¶

This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Basal Thumb Arthritis page.

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