The traditional operation for treating basal joint arthritis is excisional arthroplasty. This method has been used for many years and has withstood the test of time. The purpose of excisional arthroplasty is to remove the arthritic joint surfaces of the basal joint and replace them with a cushion of material that will keep the bones separated. Most surgeons use a piece of tendon that has been rolled up and placed into the space created by removing the bone surfaces.  After surgery during the healing phase, this tendon turns into tough scar tissue that forms a flexible connection between the bones, similar to a joint.

This operation is also combined with a reconstruction of the joint. Tendons in the area are used to create a ligament sling between the metacarpal bone of the thumb and the metacarpal bone of the index finger. This helps hold the thumb in place and keeps the space between the bones from collapsing.

The skin is sutured together and a splint is applied. The hand will probably be in a splint, brace or cast for six weeks.