Surgery for thumb base osteoarthritis can be pain-full. I use a general anesthetic with a regional anesthetic block. Immediately after induction of anesthesia a long acting local anesthetic is injected around the nerves to the arm. This usually gives at least twelve hours of comfort after surgery and avoids the need for an over night stay.
For primary surgery I almost exclusively carry out a trapeziumectomy.
The trapezium is the saddle shaped bone at the base of the thumb. Removal of this bone is a relatively straightforward operation that reliably reduces the pain of thumb base osteoarthritis.
There are other more complex operations, which can be appropriate for patients needing revision surgery. The medical literature suggests that more complex operation are not routinely more successful at improving patients symptoms. Trapeziumectomy is effective at reducing the pain of thumb base osteoarthritis in at least 90 % of appropriate patients.