Trapeziometacarpal arthroscopy: A classification and treatment algorithm

Indications for arthroscopy of the trapeziometacarpal joint of the thumb remain poorly understood. Arthroscopic assessment of the carpometacarpal joint allows direct visualization of all components of the joint, including synovium, articular surfaces, ligaments, and the joint capsule. It also allows for the extent of joint pathology to be evaluated and staged with intraoperative management decisions made based on this information. A proposed arthroscopic classification for basal joint osteoarthritis provides additional clinical information and can direct further treatment depending on the stage of disease. This article reviews the brief history of trapeziometacarpal arthroscopy and provides insight as to how this technique can be added to the surgeon's armamentarium in managing this common condition.