'Thumbs up' for innovative surgery that kept hairdresser from early retirement
A Staffordshire hairdresser who feared she may have to hang up her scissors within six months is now looking forward to another decade in the salon - thanks to an innovative new surgery, part of a pioneering national study being led by researchers at University Hospitals of Derby and Burton (UHDB).
A team from the Pulvertaft Hand Centre at Royal Derby Hospital are playing a central role in the SCOOTT trial (Surgery versus Conservative OsteOarthritis of Thumb Trial), which is exploring the most effective treatment for thumb-base arthritis - a condition that affects millions of people across the UK and can impact everyday tasks such as holding a mug of tea or using a key in a door.
For Bev Wadsworth, from Burntwood, picking up and using a pair of scissors or straighteners, or even just holding somebody's hair in place, had become second nature to her across her 43 years as a hairdresser.
In her own words: "My hands are my tools, my hands are my job".
So when thumb-base arthritis started to set in, it had a huge impact on her.
"At first, it was just small, sharp pains, here and there - but then as the pain got worse over the last two years, my grip started getting worse. My left hand in particular was terrible, and I had carpal tunnel in both hands as well - I had to cut down my hours at work, I could only cope with four hours, working three days a week, because of the amount of pain I was in," said Bev.
"You can't twist a brush, you can't hold a hairdryer, trying to hold the comb was difficult because it's the thumb that does that. So really, it impacted my life quite a lot - mentally too, because I'm in pain all the time. I absolutely love my job, but I was struggling to do it. You need to earn money but then you're in pain as well - it affects your income, especially when you're self-employed."
After seeing her GP, and with pain-relief injections not having the desired effect, Bev, 58, was referred to the Pulvertaft Hand Centre, where she was made aware of the SCOOTT trial - where patients are randomly assigned to receive one of three treatment types.
A mini-hip replacement for your thumb
Alongside the 'traditional' surgical treatment of a trapeziectomy and the non-surgical management package - which includes exercises, splints, injections and other pain-coping strategies - the trial is also offering a newer surgical technique called carpometacarpal joint replacement, which sees the damaged joint replaced with an artificial one, similar to a mini-hip replacement.
"The idea with this surgery is you get rid of the arthritic surface and you then have a moving joint in its place. The advantage of this is, hopefully, that patients can begin using it again quite quickly, they get good movement and it does provide good pain relief," explains Mr Nick Johnson, Consultant Hand Surgeon, who is Co-Chief Investigator for SCOOTT.
"As with knee and hip replacements, there can be some risks involved, but these are new designs that, so far, are showing very encouraging results, and patients seem to be doing really well. We don't have long-term data, though, which is one of the main reasons for doing the trial."
"In terms of SCOOTT as a whole, we see a lot of patients with the problem of thumb-base arthritis - but we don't know what the best treatment is for is. So SCOOTT compares those three treatment options and will follow up with more than 600 patients for about 18 months, seeing how well every person does, what the situation is in terms of pain and function afterwards. It also helps assess everything in terms of cost effectiveness and efficiency - we know that all three approaches work, but we don't know how well they do compared to each other."
This includes seeing whether patients require another operation in the future - and whether certain options allow patients to recover quicker, get back to work sooner and require less follow-up treatment, potentially helping increase capacity and reduce waiting times for patients.
As a symbol of the speedy recovery possible following the joint replacement surgery, Beverley, 58, was home on the same day as her surgery in April 2026 - and she was back in Bev's Hair and Beauty Salon, cutting her clients' hair once again, within two months of undergoing the procedure.
"Something like arthritis, it's really debilitating. Your hands are your tools, especially in my trade, so it's such an important thing the team at Royal Derby Hospital did for me. Now, after the recovery, I can go on with my career, maybe for another 10 years. I think if they hadn't helped me, I would probably have had to have taken early retirement within six months," she said.
"This really has made a massive difference to my working life - I can now work without pain. It's been a really good result for me, I'm so, so happy - the whole team were wonderful and I can't thank them all enough."
'I can do more with my hands than I could before!'
This multi-centre study is being funded by the National Institute for Health and Care Research (NIHR), with a grant of more than £2 million, and is being run by UHDB's Pulvertaft Hand Centre, alongside South Tees Academic Centre for Surgery and the University of York. Its focus is exploring efficacy across the three separate treatment options.
So, here are two more case studies from people who have benefitted from the other interventions being offered as part of SCOOTT - with their reflections on the impact the treatments and trial has had for them.
Caroline, a 58-year-old team leader for a children's mental health charity, got involved in the trial and received a trapeziectomy in November 2025, with the pain of her thumb-base arthritis having an increasing impact on her life.
"A couple of Christmases ago, I tried to pick up a heavy pan of potatoes in boiling water and I just spilled it - I was near the sink so didn't burn myself, but that made me realise I needed to do something," said Caroline, pictured below.
"The pain from little movements, opening jars, was really challenging and frustrating, because I'm fit otherwise, I do exercise. Even my yoga was causing me pain.
"The whole team at Pulvertaft were amazing, from Mr Johnson with the surgery, all the nurses, the occupational therapists, I had a brilliant service from start to finish. When I went back two weeks later, they'd given me lots of rehab exercises, I did those religiously - I'm very strong-minded! They said they'd not seen anyone heal as quickly - and now I'm back doing yoga, doing weightlifting exercises and classes, running and everything that I could do before all the pain."
As for NHS administrator Lizzie, from Langley, she has been "amazed" by the results of going through the ENGAGE programme, which is the non-surgical element of the trial that includes work with a physiotherapist and an exercise programme that the patient is given to carry out at home.
"They gave me a handbook which tells you what exercises to follow, after they've been demonstrated within the sessions. I followed each of the therapy programmes all the way through, flagged which ones I really liked, which ones were difficult, and how they could be adapted, and so the therapist helpfully adapted some for me too, so I could do them in a different way," said Lizzie.
"When they asked me how I was doing, I just said, 'I am amazed - I can do more with my hands than I could before!' Somebody was trying to open a bottle the other day and I said, 'give it here' and just opened it - I wouldn't have been able to do that before!
"I've also incorporated some of the exercises into my daily routine even now. I go swimming every day, so there are exercises I do in the shower after my swim that help keep your thumb and hands strong - I do them without question, it's just a routine. I've found it all really insightful."
Interested in signing up to SCOOTT?
The SCOOTT team are still actively recruiting to the trial - and patients with thumb-base arthritis who are interested in taking part can visit the SCOOTT website for more information >. Patients can also contact the Pulvertaft Hand Centre directly through their website > or speak to their GP about being referred to a participating site.
Explaining the benefits of getting involved in this trial and other medical research opportunities, Mr Johnson said: "You would be helping other people in the future who need treatment for this condition - and it can also be a problem that can affect both thumbs, so it may even benefit the patient themselves in the future if we find out which one is best."
More information on each of the three treatment types being offered through SCOOTT are detailed below - while you can read more about SCOOTT itself in an article from the trial's launch in 2025 >.
- Non-surgical management (ENGAGE) package – a structured programme that does not require an operation, which includes exercises, splints, task modification, pain coping strategies, and potentially steroid injections.
- Trapeziectomy surgery – the standard surgical treatment, which involves removing the small arthritic bone at the base of the thumb to relieve pain.
- Carpometacarpal joint replacement (CMCJR) – a newer surgical technique, replacing the damaged joint with an artificial one (similar to how a hip replacement is performed).
Professor Anthony Gordon, Director for the NIHR Health Technology Assessment (HTA) Programme, which is funding the trial, said: "Hearing stories like these illustrates why investing in this type of research is so important. It enables the NHS to gather vital evidence on how best to treat debilitating conditions, like arthritis, which affect such a significant number of people, and make even the most simple everyday tasks that we take for granted much more difficult.
"The NIHR celebrates its 20th anniversary this year, and over the past two decades, we've consistently funded research like this, which makes a real difference to people, helping them to stay in work and live happier, more productive lives for longer."