Background: Thumb base arthritis is a common condition. Arthroscopic or arthroscopic assisted procedures offer better visualisation, less invasiveness and faster recovery than traditional open procedures; it also helps to guide decision making if further treatment is necessary. Methods: A review of cases who received arthroscopic procedures from April 2002 to August 2013 was performed. First carpometacarpal joint arthroscopic debridement was done in 76 patients, and synovectomy was performed in 65 patients (female 51, male 14) with an average age of 56. All patients failed nonoperative care for 6 months. The average follow-up duration was 59 months. 38 cases were Eaton & Littler Stage II, 36 Stage III, I Stage IV and I Stage I. The operation was done under local or regional anaesthesia. Synovectomy, debridement of frayed capsule and radio-frequency ablation were done in all, loose bodies were removed in 25, and thermal shrinkage was done in 30 cases. Post-thermal shrinkage immobilisation was given for 3-6 weeks. 12 cases had smoothening of the bony surface & prominent osteophytes. Results: 69 cases experienced pain relief after the operation. 20 cases had excellent and 14 had good result. Mean grip strength of 88.3% of the contralateral side while pinch power of 81.7%. Kapandji index was 8. DASH score was 26.5%. Patient satisfaction was 77 of 100. There was no complication encountered. 7 patients requested the same operation on the other thumb after the operation. 3 requested repeating the same operation on the same thumb as pain relief lasted only for 1-3 years. Better outcomes were found to be statistically related to bone surface smoothening, or thermal shrinkage and immobilisation for ≥ 4 weeks. Conclusion: Long-term results of arthroscopic debridement and synovectomy, the surgical techniques, and the examples of arthroscopic assisted procedures at the thumb base were demonstrated and discussed. Arthroscopic surgery for thumb base arthritis is a safe and feasible procedure that can provide long-lasting symptom relief.
