I'm weighing up surgery on my thumb joints

Dear Cindy here is the new surgery using stem cells but because it is so new and they’re not so sure how long it will last I would stick with the traditional basil fun osteoarthritis removal of the trap his own phone and putting a tendon in there that is guaranteed for minimum 25 years.

Cindy,

I did not have arthroscopic surgery (which sounds preferable) but had the trapezium removed and ligament used to re-connect bones.  Unfortunately my bones crumbled and required 3 pins and 2 incisions.  My pins were actually from the base of the thumb toward where the trapezium is normally.  Spent 2 weeks in a splint then 4 weeks in a cast. (This followed the same 2/4 protocol a few months earlier due to fractured wrist.)  Pins were removed (not as painful as expected) and cast off this past Wed. Now have a "soft" brace and start PT Fri.  Of course the thumb/hand is sore and incisions are very tender, but the arthritic pain from the thumb that was there pre-surgery is GONE!  I am very hopeful and glad I had the surgery.

I'm confused why you would be in a cast following removal of pins but different Dr's do things differently.  Or could he have just meant a total of 6 weeks in cast rather than 12?  For me the casts were the worst part but worth it if this turns out as good as I'm expecting.

Please keep us posted on what/how you do.

Wishing you the best.

Linda

Hi Cindy, I had LRTI surgery 2 wks. ago today and doing well. The trapezium was removed and they used a piece of tendon to connect and use as cartilage replacement. Have watched the YouTube video on line several times and think it matches what I've had done. No pins used, however. You may have more than the usual damage. Never hurts to get a second opinion. The surgery was not as bad/painful as I had anticipated, took Rx med not even 48 hrs., then Aleve for a few days at nite time. Did a lot of icing for about a week and think this also was a great help with the pain.  Hard cast was removed last Thursday and now have a splint that wraps around thumb and goes down to elbow, rest of fingers free, making it a little easier to navigate since it's my dominant hand. Will wear this splint 24/7 for 3 mos. and then a half splint for ? mos. I start PT tomorrow, although when cast was removed was able to make a fist, no numbing, tingling which they said was good. It was.a great help to be on this forum and read of other's experiences, knew what I was in for and got a lot of good tips and encouragement that this may be a long haul but worth it not to have the constant pain. Have to say I'm sleeping straight thru the night, for longer hrs. since the surgery. Did not realize that I was getting so little sleep because the thumb ached all the time! I'm beginning to have the same twinges in my left hand and will not hesitate to have that one done as well. My theory is: it's not going to get any better, arthritis only gets worse and I'm not getting any younger (turned 76 yesterday!), I have too many things I enjoy doing that requires my thumb, so will not hesitate to do it again! Good luck and let us know what you decide.

I have not heard of that one.  I had the mini-tightrope procedure which is a newer alternative.  Only two weeks in a cast and then you can start using your hand again, just no weight-bearing usage for the next four weeks. But typing and washing and brushing and eating is fine.  They don't use cartalidge for the empty space, just let it fill in with blood and scar-tissue while the tightrope holds it in place.

The whole procedure went really well. 5 days of Oxy, 5 days of ibuprofen, and haven't taken a pill since.  I just passed 16 weeks and have about 75% strength back and occasional wrist and thumb soreness.  Nothing like the pre-surgery pain.

Nice to hear.   I am post op week 7.  Same thing.     Are you able to resume all things like possibly biking and gym activities ?  Any limitations ?  

The mini tight rope is the way to go.   

I am doing everything now - installed a heavy closet door this weekend which I would not have been able to do pre-surgery.  The wrist is still sore when I fully flex, the thumb is mildly sore when I "lift" it up, and the area where the bone was removed is sore when I lift heavy things, open a stubborn jar, and press my hand down totally flat or give the thumbs up sign.  Doc says soreness will continue to dissipate over time.  I was at the gym yesterday and overhead press with a barbell is uncomfortable but still fine. The PT mentioned that the wrist bones will readjust how they all work together as they get used to having one less teammate (the Trapezium), causing the wrist soreness.

The amazing thing to me is that it doesn't ache at all when I am not using it.  I used to take ibuprofen several times a week, or more. I have not taken it once over the past 2 months, even for other aches and pains, which makes me think the thumb pain was causing more overall discomfort than I realized.

If you are a biker, I could see that the jarring on your wrist could be a little painful, especially mountain biking.  Road biking should be fine at 16 weeks - for me it would have been impossible before the surgery.  At 12 weeks I started doing most activities and had good range, dexterity and fine motor control.

How is the recovery going for you?

Very nice to hear you are doing so well.   

Wow. You sound incredibly active. And I am very happy to hear you have recovered so well. 

I am able to text with out issues with the thumb.  Week seven. Got good range of motion. The strength isn’t back yet but doing therapy 2  - 3 times a week.   

Biked a bit. Surprisingly. Riding my Mtn bike on the road was better.  Less pressure on the space between the thumb and first fingers.  

Your pain is gone because the arthritis region has been removed.  

After a long day of light duty at work.  It’s sore.  So I am icing it.  

I can’t wait to be 16 weeks post.  

I no longer wear my brace to sleep or anywhere.   I do use it to bike for now.  

Pulling up my pants is still a bit difficult or buttons.   But. In time. 

I am very happy with my progress.   

Good to hear from you and a person that is 9 weeks ahead of my timeline.  

Thanks 

Art 

this is the same surgery I had done on my second hand - I am three weeks out.  Cast removed in one week.  I then wear a removable splint for month or so and do hand exercises on my own.  First hand very successful, although it is sore right now as it is bearing the brunt of not using my left hand.  Surgeries very successful and are a game changer for me as I am in my early 50's and will be working another 15 years. 

Glad you are on the road to recovery.  

Hi Flanger.....at last a proceedure that I would consider having. I'll be doing some research on this. I have delayed surgery up till now because quite frankly the recovery time seemed way too long. 

Thanks for the tip, I'll check it out.

There is a Youtube video that documents someone's journey with the procedure.  Some of my experience was perhaps a little easier than hers.  However, at then end I think she ended up with a little more extension at the piano than I would have (at least so far). (or Youtube search "mary racine cmc basal #1".

The whole procedure ended up being less of a big deal than I thought.  Surgery on Friday, relaxed for the weekend, then back online working Monday.  The Oxy got me a little high, but nothing too bad that I couldn't think.

Arthur - yes, buttons are a good test .  I think that got better somewhere between 12 and 16 weeks. And a firm handshake is finally getting to where I don't wince.  I ended up asking for with fist-bumps for about the first 12 weeks .

 

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I was thinking about this one too.  So far the arthroscopic one I mentioned is only done in Iowa.  Where did you get the mini-tightrope?  Do you knif it's available in the Northeast US area?

Cindy

I got the mini-tightrope done in Colorado (Boulder, Dr. Master).  I think he trained under Yao, who may be the guy behind the mini-tightrope. The company that makes the equipment is Arthrex and you should be able to learn more about it by searching for Arthrex Mini-Tightrope.  They have a great animated video that shows what the procedure is.  They also have a live surgery video that I suggest you do NOT watch - I might not have had this done if I saw that video beforehand .  Perhaps Arthrex would have a list of docs doing the procedure (with their equipment).  

I too would like the mini-tightrope verses the CMC version.  However a friend of mine had what is called a suture suspension which is similar to the tightrope but without the wire.  foreign objects in my body freak me out.  The dr who did hers is almost 2 hours from me, so not sure how that would all play out with therapy and such.  I have chosen to wait until my husband retires so I'll have at least some help.  Doing all that  traveling in Chicago winter is brutal.  It seems most who have these surgeries are in a lot of pain all the time.  Mine is limited to when I overdo gardening etc.  I rarely take anything for pain so just not sure its time yet.

Hi Sheila, 

I'd say you are nowhere near needing surgery. My arthritis is much more advanced than yours but I have managed to avoid surgery for 4 years now. It is slowly getting worse. So far I have managed the pain by a variety of methods. 

Topical arthritis creams

Beef gelatin

arthritis compression gloves ......these work very well ...pain is reduced dramatically as soon as I put them on. 

These don't work for everybody but are cheap and worth a shot before undergoing expensive surgery. There are some here who have tried these with no success and I am sure will be quick to jump on here and tell you they don't work. 

So far during the 4 years that I have been able to put off surgery there have been significant advancements in surgical techniques. E.g. Arthroscopy. 

My next step will be to try stem cell treatment which promises 50% pain reduction for a period of two years. I just can't afford the long recovery time of conventional surgical proceedures. 

Private message me if you'd like more details. 

finally someone who gets where I'm coming from.  I see the stem cell research and also the stuff they use in knees is being tested for thumbs.  Hopefully when I get to the point of no return technology will be even more improved.  I have braces and creams and a molded brace I wear when I have flare up.  I'd love to pm  you but not sure how.  p.s. I've avoid the cortisone because it increases the bone spur growth but that something your doctors don't tell you.

Hi Sheila, I just sent you a private message....you can just reply to that. 

Cheers 

I just had my nasal thumb with putting a tendon from my wrist on October 6th. I am now one month out. I can touch all tips if my fingers.  I can also such as the bottom of each one of my fingers.  I only took pain medication for three days.  then switch to ibuprofen among them.   I am now on my third cast which is a removable cast.  Recovery is slow I have some numbness on the top of my thumb and down my wrist slightly.   I had my left thumb  operated on.   Dr. said my surgery went very well. I was diagnosed with end-stage osteoarthritis of the thumb. Very severe.  Still have slight pain here and there and I am starting already exercises at home. Will go back on December 14. This will be six weeks from today. I believe recovery will take up to one year. After my six weeks are up on December 14 th I will start occupation Therapy.   I have checked out the stem cell surgery along with many other options of surgery and I believe the tendon replacement is the best surgery for today’s standards it has over a 90% success rate. Stem cell therapy only lasts a few years and then you have to have it done again and if the bone completely deteriorates you will have to have the surgery I just had done. Good luck to you my prayers are with you. 

 Just to let you know that I have investigated the many type rope surgery before I got my tendon surgery.  The tight rope surgery does not last very long within five years you’ll have to have the full tendon replacement surgery so I suggest you go with a Doctor Who can do the basil from tendon replacement surgery. I went with Dr Brian Bear out of ortho of Illinois in Rockford Illinois they are the best .