Updated: Jul 30 2021
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The STT joint is really a set of small joints on the thumb side of the wrist (see picture below). The three bones involved in the joint are the Scaphoid, the Trapezium, and the Trapezoid, hence STT joint.
Conservative treatment includes splinting and corticosteroid injections. Operative treatment consists primarily of fusion of the STT joint, although alternatives include trapeziectomy, fibrous arthroplasty, and prosthetic replacements.
The most common symptom of osteoarthritis of the carpometacarpal (CMC) joint or scapho-trapezium/trapezoid (STT) joint, is pain at the bottom of the thumb. The pain can be worse with activities that require pinching, such as opening jars, turning door knobs or keys, and writing.
Eaton and Littler originally described Stage IV CMC arthrosis with advanced degenerative changes, including substantial subluxation, joint space narrowing, and subchondral cysts and sclerosis (Fig. 1D). They stated that this stage was “generally applicable to rheumatoid arthritis” .
Scaphotrapeziotrapezoidal (STT) joint osteoarthritis has been estimated to account for 13% of all wrist arthritis cases and can cause significant pain and limitation of function [4-6]. Common predisposing factors are trauma, an abnormal trapezio-trapezoidal inclination and laxity of the capitotrapezial ligament [4-6].
The STT joint is one of the intercarpal joints and involves multiple articulations, including those between the scaphoid and trapezium bone, and between the scaphoid and trapezoid bone.
STT fusion involves joining the three bones together to prevent movement at the joint. The operation involves the surgeon removing the surfaces of the joint. A small bone-graft is taken from the hip-bone (ileum) and this is packed into the STT joint to encourage the bone surfaces to join together.
Aim of pyrocarbon STT arthroplasty is to relieve pain and preserve wrist motion and function by maintaining height and kinematic of the scaphoid. Severe midcarpal instability associated with STT joint destruction is a contraindication of pyrocarbon interposition.
Triscaphe degenerative arthritis is the second most common type of degenerative arthritis in the wrist. The most common is the pattern of destruction associated with a scapholunate advanced collapse (SLAC) wrist. The diagnosis is relatively easy when radiographs confirm the isolated joint destruction to the STT joint.
Arthritis vs. Arthrosis. Arthritis is an inflammatory condition involving one or more joints throughout the body that causes pain, swelling and warmth in the affected areas. Arthrosis is a non-inflammatory degenerative condition associated with aging.
The scaphoid bone is one of the carpal bones on the thumb side of the wrist, just above the radius. The bone is important for both motion and stability in the wrist joint. The word "scaphoid" comes from the Greek term for "boat." The scaphoid bone resembles a boat with its relatively long, curved shape.
Basal joint arthritis is a very common type of arthritis that affects the part of the thumb that's right next to your wrist. It occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb. It causes pain, especially when you try to pinch or grab things.
Hyperextension at the MCP seen in end stage CMC arthritis occurs to compensate for the loss of motion at the CMC joint. Diagnosis: CMC arthritis is diagnosed through physical exam and radiographic evaluation. CMC treatment is deter- mined by the stage of the disease.
You will generally have no pain, and the numbing medication usually lasts about 8 or more hours, so you will leave the surgery center with no pain.
Thumb carpometacarpal osteoarthritis (CMC OA) is a common disease, affecting up to 11% and 33% of men and women in their 50s and 60s, respectively, which leads to pain, laxity and weakness of the CMC joint.
The most common symptoms of osteoarthritis are stiffness, swelling, and pain. Bony nodules may develop at the middle (PIP) and end (DIP) joints of the finger. A deep, aching pain at the base of your thumb is typical of osteoarthritis in the basilar joint.
Causes of Metacarpophalangeal (MCP) Joint Arthritis
Inflammation (mainly rheumatoid arthritis) Traumatic injury leading to broken bone or loss of cartilage (Post-traumatic arthritis) Routine wear and tear of the MCP joint (osteoarthritis) Certain medical conditions (gout, pseudogout, psoriasis, etc.)
The CMC joints are located between the distal carpal row and the metacarpal bones (Fig. 13.54). Each metacarpal and its associated phalanges make up a ray of the hand. The CMC joints are enclosed by a single joint capsule.