Osteoarthritis of the basal joint of the thumb is common, particuLarLy in postmenopausal females. The male to female ratio is 1:10 respectively. Basal joint arthritis can cause considerable pain and disability. Incompetence of the volar beak ligament is thought to be the pivotal injury that will eventually lead to joint degeneration. Patient history and physical examination can reliably lead to the diagnosis. Radiographs are used for the evaluation of the severity of the arthritis and for treatment strategy. Conservative treatment can be effective in the early stages of the disease. Operative treatment has been shown to be successful in relieving pain and restoring thumb function. The majority of reconstructive procedures include partial or complete trapezectomy with beak ligament reconstruction and tendon interposition.