What is scapho-trapezium-trapezoid arthritis?

STT Arthritis (scaphoid-trapezium-trapezoid arthritis) is a rare form of arthritis involving a very specific joint, the scaphoid-trapezium-trapezoid joint. The condition is poorly understood as it affects a very specific joint and is associated with flexor carpi radialis (FCR) tendon synovitis, with the development of a bony tunnel around this tendon as it runs over the STT joint.

Any wrist movement towards the thumb side will compress the joint. Over time, with the loss of all cartilage in this joint, there will be severe pain with most wrist movements, making a fist and using the thumb.

What are the related symptoms of STT arthritis?

STT arthritis' common signs and symptoms usually are pain on the front side of the palm and on the thumb side. Other symptoms may include difficulty in pinching or gripping with your thumb, and if adjacent joints are also affected, STT arthritis symptoms may spread to the wrist and thumb.

STT arthritis before surgery

How is STT arthritis treated?

Dr van der Spuy may recommend conservative treatment for STT arthritis, such as anti-inflammatories, cortisone injection and even wrist splinting, but in the long term, with progressive joint deterioration and complete loss of cartilage. Pain is produced by bone grinding on bone and severe inflammation of the overlying FCR tendon.

If the pain becomes disabling and incapacitates activities of daily living, the hand surgeon may perform a small procedure that excises the distal pole of the scaphoid, called an excision arthroplasty. This surgery is performed to create a void between the bone surfaces that are grinding on each other, causing the pain. The hand specialist will then fill the void with an interposition of a small piece of the tendon that creates pain-free articulation.

Rehabilitation includes two weeks of immobilisation with the use of a thumb cast after the surgery. Dr van der Spuy will later use a thermoplastic thumb and wrist splint to replace the cast.  He will then recommend a range of movement exercises and light activities are gradually introduced at 4-6 weeks post-surgery. Most patients do well and can use their wrists after three to four months without pain.


1What are the signs of STT arthritis?
  • Pain at the base of the thumb
  • Pain worsens when turning knobs, writing or opening jars.
2What results in trapezium bone pain?
Basal joint arthritis is a common condition affecting the first metacarpal joint and trapezium.
3Is there a surgical procedure for STT arthritis?
Yes, your surgeon may decide to perform a partial excision of the scaphoid with a tendon interposition to cushion the new joint.

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.