CMC Arthroplasty — Thumb CMC Arthroplasty

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation · Dr. Gander; Dr. Kruse; Dr. Michelotti; Dr. Salypongse; Dr. Tofte; Dr. Zachary

Weight-Bearing

NWB surgical UE

Key Restrictions

No resistive gripping or pinching; no lifting >1 lb Phase I; no resistive pinch/grip until 8 wks post-op

Timeline & Phases

Phase I (5–14 days): forearm-based thumb spica (IP free, MP 30° flex, slight abduction, wrist neutral); AROM digits 2–5 and thumb IP; scar/edema control | Phase II (10 days–3 wks): gentle wrist AROM all planes; continue digits 2–5 AROM; desensitization; no resistive grip/pinch | Phase III (4 wks): transition to hand-based thumb spica (IP free); thumb IP/MP/CMC AROM; stability exercises thumb MP/CMC; light prehension within orthosis | Phase IV (6–8 wks): wean orthosis; hand-based for heavy/night; AROM and AAROM composite thumb flexion/opposition/extension/circumduction | Phase V (8–12 wks): functional use; joint protection education; PROM composite thumb; strengthening at 12 wks

Notes

Thumb CMC joint arthritis/instability with significant pain; inability to flatten palm expected post-op (normal); thumb/hand swollen 6–12 months post-op (normal); return to work ~2 weeks; developed collaboratively by UW Health and UnityPoint Health - Meriter Rehabilitation

Surgeon / Author

Dr. Gander; Dr. Kruse; Dr. Michelotti; Dr. Salypongse; Dr. Tofte; Dr. Zachary