The paper presents a clinical review of patients operated by different procedures for disabling osteoarthritis of the carpometacarpal joint of the thumb. Fusion of the joint resulted in pain relief, and the patients achieved a stable thumb with excellent strength. Although a minor loss of thumb motion was noted, this was not considered a problem. Excision of the trapezium gave good results with respect to pain relief, but there was loss of thumb stability and strength. Implant arthroplasty with a silicone prosthesis appeared to give a painfree, stable and mobile thumb, but there was loss of power. In conclusion, arthrodesis is the method of choice if reduction of strength is to be avoided.