When software developer David Hellyer started to lose strength in his left thumb, he realised just how integral the opposable digit is to daily life.
“I do a lot of work on the computer, and I’m also a PS4 gaming enthusiast. Both involve pressing down with the thumb and over many years this repetitive action contributed to wear and tear on the joint at the base of my thumb,” David says.
| David Hellyer Ducati: David Hellyer has returned to one of his favourite pastimes, riding his Ducati road bike. Before his thumb base replacement, the arthritis in the base of his left thumb had started to affect his grip and threatened his ability to ride his motorbike, as well as perform other daily activities. |
| David hand scar: David’s hand has regained full strength since his CMCJ replacement procedure, and the small scar is barely noticeable, positioned along the edge of his hand. |
“I also love riding motorbikes, and operating the clutch requires stretching your hand in such a way that it adds further strain to this joint. At first, I felt a bit of pain in my thumb, nothing too serious, and I still had strength in my grip, but over the next 15 years, it gradually got worse. The X-ray of my hand clearly showed the wear and tear on the thumb base joint.”
“Most people never realise how important the thumb is until using it becomes painful. Mr Hellyer’s arthritis was caught relatively early, before it could progress to cause significant pain, joint deformity or start seriously affecting his independence,” says specialist hand and upper limb surgeon Dr Ashley Naidoo, who practises at Netcare Waterfall Hospital’s Sports Orthopaedic Surgery (SOS) Centre.
“Simple daily activities most of us take for granted, like opening a jar, turning a key, holding a coffee mug, typing on a phone or picking up your child, require fine and intricate movements of this joint. For people affected by advanced thumb base arthritis, also known as thumb carpometacarpal joint (CMCJ) arthritis, these tasks become constant reminders of their progressive condition,” he explains.
Dr Naidoo points out that CMCJ arthritis is one of the most common causes of hand pain in adults, particularly in women over 45 and in individuals who work with their hands or spend a significant amount of time on computers.
“Even though it is so common, many people mistakenly believe the pain and loss of function they are experiencing are simply part of getting older and don’t realise how much can be done to treat thumb base arthritis,” says Dr Naidoo, who gained international experience at the Oxford Hand Unit, the American Society for Surgery of the Hand, and Harvard University among other travelling and visiting fellowships.
With early orthopaedic assessment, conservative treatments can ease symptoms initially and help delay progression. These may include thumb splints or braces, anti-inflammatory medication, ergonomic changes and modifying one’s activities to avoid repetitive strain.
“Corticosteroid or hyaluronic acid injections are recommended for certain patients as an option before surgery is considered,” Dr Naidoo says, adding that hand therapists and occupational therapists also assist in maintaining function and reducing strain on the affected joint.
Surgery is only considered when the condition starts to affect the person’s life, often impacting sleep quality and making their daily activities more difficult. In David’s case, his grip and pinch strength were deteriorating, which could become a problem when riding his motorbike.
“Several years ago, I broke my foot and had to have a series of operations before I could ride again. I’m no stranger to traditional surgery, and I was eager to have as little downtime as possible, given how crucial the thumb is in my work as a software developer, not to mention for riding and gaming, which are also a big part of my life.”
Historically, the most common surgery for thumb base arthritis involved removing the trapezium bone, often combined with tendon reconstruction techniques. While trapeziectomy remains an effective and reliable procedure, Dr Naidoo points out that recent advances are opening up new treatment options.
“Today, hand surgery is no longer solely about removing arthritis. Increasingly, it is about restoring quality of life, preserving independence, and helping people continue to do the things they enjoy most. The introduction of thumb carpometacarpal [CMC] joint replacement surgery reflects the broader international trend towards precision and function-preserving orthopaedic care,” he says.
Thumb CMC joint replacement surgery involves replacing the arthritic thumb base joint with a specialised prosthetic implant designed to recreate natural thumb movement. Rather than removing the joint entirely, the replacement preserves the mechanics, enabling thumb movement while relieving pain.
| Before surgery: An X-ray taken before surgery shows thumb base arthritis, also known as thumb carpometacarpal joint (CMCJ) arthritis, which caused David Hellyer to lose grip and pinch strength in his left hand. |
| After surgery: David's arthritic thumb base joint was replaced with a specialised prosthetic implant designed to recreate natural thumb movement, preserving the joint’s mechanics and enabling thumb movement while relieving pain. |
“International studies and systematic reviews have demonstrated the value of this option in clinically appropriate instances, with quicker functional recovery and improved early strength restoration among the noted advantages,” Dr Naidoo points out.
“This new generation surgical approach offers better preservation of thumb movement, improved self-reported functioning and comparable pain relief to trapeziectomy procedures. Other comparative studies have highlighted improved functional outcomes and preservation of thumb biomechanics with modern arthroplasty implants.”
It has been over a year and a half since David’s CMC joint replacement surgery. “I had the procedure in November 2024 and recovered over December, returning to work at the beginning of 2025. The surgery itself was relatively minor, and I did not even need to spend a night in hospital, and my recovery was pretty easy,” David says.
“My hand has returned to normal strength, and I can do everything I did before. Occasionally, after using my thumb a lot, it may feel a little tired, but the results have impressed me. Aesthetically, there is barely a trace of the little scar left. Dr Naidoo’s incision was small and positioned on the edge of my hand, where it is not noticeable. Best of all, I’m working, gaming and making up for lost time riding my Ducati road bike.”
“Treatment for thumb base arthritis often means restoring far more than just the affected joint; to the person, it often means restoring confidence, independence, and simple enjoyment of everyday life,” Dr Naidoo concludes.
Ends.
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