I'm weighing up surgery on my thumb joints

Posted , 148 users are following.

I have osteo arthritis of both thumb joints. I'm 70, still very active ( currently on a skiing holiday) and work full time in my business. My condition is getting increasingly painful. I get by with painkillers. I have seen a surgeon but I'm really concerned about the long recovery time. 

Has anyone here had basal thumb surgery and if so would you mind describing...briefly...what the surgery and recovery like and any complication. I would be most grateful.

Cheers. 

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  • Posted

    Hey all -- just thought I'd throw in my 2 cents worth on this conversation, as I had right hand cmc arthroplasty with tendon transfer back in 12/2014. The first post-op weeks were definitely painful and frustrating. I'm right handed, so it was difficult to do much of anything. An electric toothbrush was a huge benefit for the first couple of months, but I'm back now to a regular one. Rehab was also painful and frustrating, but if I had it to do over again, I'd definitely have the surgery. I'm 66, very active (bike, ski, kayak, hike, strength train in the gym, garden, etc.), and live alone, so need both hands. The pain and disability of arthritis in both thumbs led me to an early retirement from my job as an RN -- I couldn't open pill jars, grip IV cannulas, or even hold a pen properly to chart without great pain, so retired a year before the surgery. I could work again now, but at 66, have lost my interest in all the administrative crap that comes with the job. Caringbah--within 6 months, I was able to kayak hard for hours at a time, (it gets a little achy, but nothing like before), lift free weights, dig in the garden and pull weeds, etc. I went skiing and snowshoing (both with poles) last winter without giving the thumb a second thought. Arthritis in one knee recently ended a 45 year stretch of running (4 to 15 miles several days/wk), so I bought a great road bike and am doing 20 to 35 mile workouts on it. Because of pain during and after shifting gears with my left hand (need that granny gear for big hills!), I'm getting ready to have the left thumb done too. I'll wait till November, in order to not lose a lot of spring/summer/fall outdoor activities. I'd say that surgery decreased the pain level by 90%. If I didn't use my hand so hard, it might be closer to 100%, but if I'm not active, I'm not a happy person! Grip strength isn't what it was years ago, but much better than before surgery, and sufficient for living well. I think the secret to a good outcome is going into it as healthy as possible and finding an excellent surgeon who's done lots of these procedures. Definitely don't get it done if you can function as is, but I couldn't, and I'd read in many places that once pain stops us from using the thumb and it weakens a lot, we're much less likely to have as good an outcome as if we'd done it while we still had some decent strength. Kind of a use it or lose it situation. Good luck to all, including me :-)      

    • Posted

      Good to hear you are doing so well. My op on 1st hand is 4 weeks tomorrow & just want to get the journey started now!

      Here in the U.K. the more usual surgery is Trapiezectomy. My surgeon is a hand specialist & has done many of these procedures. It does not involve the tendon transfer I believe.

      Hoping my outcome is good but have been warned that it may be a year before I realise the full effect. I'm a music instrument teacher & keen crafter, so hoping to be able to get back to all of that. I know my other hand will need doing at some point but will see how this goes.

      Good to hear positive outcomes. Wishing you well with your other hand surgery when the time comes.

    • Posted

      ginger8, it sounds like you are in U.S.? Have been following Devonia and others out of U.S. and waffling in getting thumb fixed. But since I've realized it's not going to get any better, I'm getting older and my existing health ins. ends in Dec., have gone ahead and scheduled 9/25 with a hand specialist at Cleveland Clinic for "carpometacarpal orthoplasty, ligament reconstruction, tendon interposition". In my other words, a new thumb! Am assuming most on this forum have had very similar surgeries by different names. It sounds like you've had optimal results and hoping mine will be the same. You mentioned the lack of use of hand will weaken and that reaffirms my decision to go ahead b/c that's exactly what is happening. Since I'm right handed, have been trying to use my left as much as possible both to save right but now also in prep for not having use of right. How long post-op before you could you use your dominant just for everyday use, I.e., help to get up out of bed, getting dressed, driving, etc? Any tips from you and/or any would be helpful. This is scary for me but keep reading about, for the most part, success and relief of pain, so keep posting all!

    • Posted

      I'm in much the same position pain-wise. I'm also one of the wafflers but changed my mind after a surgical consult. I did research on surgeons and I'm lucky that I got to see Chair of hand surgery at a research/teaching hospital. I asked about the mini-trapeze done at Stanford and he explained why he doesn't do it. I'm convinced and do plan to have the LRTI surgery which sounds the same as what you've scheduled. I'm a fit and active 67 year old woman and I'm more than annoyed by the inconvenience but the surgeon promised the procedure will last forever. I'm just trying to figure out what the least inconvenient time is to schedule. Good luck!

    • Posted

      Thats mini-tightrope NOT trapeze. Ha!
    • Posted

      Thank you for your insight. I love Mtn and road biking. And was afraid that after the surgery. With the Tri podding you must do with your wrists. You would be putting too much pressure on the post surgical site. And. Could cause damage.

      Your words are very encouraging for the biker in me. Good luck with your surgery. Second one. And would like to hear your results.Did you consider the mini tight rope ?

    • Posted

      Thank you Ginger! Your post gives me great confidence to move forward with the surgery. Sounds like I am in the same position as you were before the surgery! Again thank you! - Julie
    • Posted

      Hi Kathleen -- yes, I'm in the US. My memory of the early recovery is fading, but I do know I was caring fully for myself within 2 weeks -- driving myself to PT appts, etc. Within 3 months I was riding a bike on the beach, and by 5 months kayaking. The early recovery was weird -- I remember feeling like my thumb didn't belong to me -- little strength or control over it and a fair amount of pain when picking small objects up, but I did what I was told to and it improved steadily. I'm not looking forward to the second surgery, but there's no way that I'll not do it.  The first surgery was scary for me too, but I'm SO glad I did it!!!   

    • Posted

      Arthur--I've been riding around 60 miles/week, limited from doing more mainly by my left hand (that'll be fixed this winter). Sometimes the area at the base of the right hand gets a little sore at about 25 miles out, but it seems to be from the pressure of shifting when I do a lot of hills. I don't think it's causing any harm to the joint--just making it a little tender. It's not bad enough that I even need Tylenol or to ice it after--just enough to make me be more careful than I would have back in my younger days.  

      No to the tight rope!  I did have steroid injections, but they hurt like the devil when they were administered and didn't help one bit.    

    • Posted

      You're welcome, Julie! I talked with a few people in the PT department who had previously had the surgery on one hand and were back for the second hand -- all said that they had great results from the first fix. One guy said that he had a lot of post op pain for around 6 months, then all of a sudden it went away and never came back. That was a strange story, but the ultimate outcome was good enough to make him do it again. I'd guess that he had a little nerve damage that took a while to resolve. Nerves heal very slowly.   

    • Posted

      Wow, Devonia -- sounds like you're about to go in for your surgery!

      The doc told me too that it could take a year, but I was doing well, using my hand normall, and not giving it much though after a few months. I guess it all depends on what shape we and our hands are in, how we care for ourselves after, how well we follow the PT program, etc. You sound like you'll be motivated to behave yourself :-)  

      Good luck!!!  Can't wait to hear your success story. Even if some complaining comes before it.....  

    • Posted

      Thank you. I should be going down for surgery in 20 minutes or so!

      Will let you know :-)

    • Posted

      I just got up (8:00am here) -- you must be in recovery now, sporting a new thumb joint! I hope someone pampers you over the next 48 hours!!!   
  • Posted

    I had surgery last August-tendon replacement with a pin. It's been a nightmare. There were serious complications with the pin. It got stuck as they were trying to remove it!! I'm sure this has left permanent damage. I have very little strength in my hand and limited movement. My thumb is useless. And, the other hand needs "something" done to it too. My dr has said the recovery takes a year. I'm assuming in 3 weeks my hand is going to become miraculously cured.

    • Posted

      So sorry to hear that Teresa , I have arthritis in both thumbs and am seeing one of the best surgeons in my area But too many have had horrendous complications after I have decided not to go ahead with the trapeziotomy. I recently had the injections and this time they have worked. Plus I use voltarol gel and bought a Push thumb splint. Really good results so I will stick with that. I hope you eventually get a bit of relief x

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