I'm weighing up surgery on my thumb joints

HI Kate,

Thanks for that. I have to tell anyone reading this that it was Kate who really helped me. She lives in Sydney and i live in Brisbane....1000km away. We didnt know each other from a bar of soap but she tracked down a Brisbane practioner for me and the results have been great...still one more set of injections to go.

I would strongly reccomend anyone considering surgery to try PRP (platelet rich plasma) first.

Hi Geraldine. Thanks for your honest appraisal of your surgery. i am so sorry it didnt work out for you. your account and many others like you have convinced me to avoid surgery at all costs.

we get people on this site saying that only people who have had unsuccesfull surgery complain....the people who have had successfull surgery dont complain ....or so they say.

well in my opinion thats a pretty unsubstantiated claim....where are the stats? are there any stats?

Can you really trust a surgeon to give you an honest answer?

hi Carin. yes I totally agree with you on all points. Actually sometimes my hand feels like a paddle not at all flexible! Wishing you all the best toward a new treatment which really works.

Hi! I am sorry to hear of your outcome but also happy because it makes me feel less insane . Today is my 6th month anniversary I also followed all doctor and therapists orders. I also am in more pain than before surgery but now have the added pain and weakness of the forearm. My doctor does not want to be bothered; because he says it takes a year. I understand that but feel I should be seeing some improvement and not decline He said he has NEVER seen a patient complain of forearm pain and has NO idea of how to help resolve this. My left arm is also now very painful because I'm doing most things with it I went to the best hand surgeon in town and don't know where to turn.

This sight is so positive, i really hesitated even writing I'm at my wits end

hi Donna, sorry to hear of your pain, seems we are both in tune, my surgery was 28 May - as you say it is good to know that our pain is shared and we r not totally bonkers! lets swap stories after 3 more months and see if we are any better! another problem I now have is my pinkie is totally painful and sort of bent toward my fingers, the doc says oh it is just arthritis! well it wasn't like that before!!! Anyway take care and do not despair. Regards. G

Hi Donna, I haven't been keeping up with this forum or posted anything for a very long time, apologies! Wanted to let you know that I had forearm pain after my surgery in January. My surgeon talked me into having a full thumb joint replacement. Surgery seemed to go well, it was extremely painful though. Within days after surgery I developed pain in my forearm, it was causing me more problems than my thumb. The physiotherapist insisted that it was tendons complaining after being moved out the way, to expose the joint. It took about three months for it to ease from the arm and is now in the wrist. Its not continuous anymore, it comes and goes. If it is the tendons, it is a very slow recovery for them. The thumb seemed to be healing well and I was really pleased that I had had surgery. However, pain has started to develop again in the joint and further up towards the wrist.The surgeon has recently informed me that its quite common that if the thumb joint starts to decay, other bones in the area can also go and that is what may be causing pain again.

X-rays look OK and the implant has stayed in place so am baffled and frustrated. Some days it's more painful than my right thumb which I'm waiting to have surgery on. He doesn't want to operate till my left hand is completely healed and I'm now querying whether I want to have such an invasive operation again. Wondering if having the trapezium bone taken out would of been the better option. Surgeon talked me out of that saying that I may not get full strength and movement back afterwards. Is that true? Never quite know who to believe.

You are obviously referring to me, yes a high percentage of people here are here because they have had issues, but speaking to my surgeon and another surgeon who is a son of a very good friend says that whilst there are unsuccessful operations for this procedure, they are actually quite rare. At least here in Australia. I have known this guy since he was a baby and seen him grow up and go through medical school all the way to become the orthopedic specialist he is today. He would have absolutely no reason to lie to me and I know him as an fine person with exceptional ethics. If you remember before I had both mine, I communicated with you and tried a couple of ideas that you had some success with, neither of which worked for me. This is just the way things are, what works for one will not necessarily work for someone else. I was quite wary about the operation myself and got in touch with my mate's son about it. He said yes there are instances of unsuccessful outcomes with this, but from his experience they were quite rare, especially if they are were performed by qualified orthopedic specialists. I took the chance and the rest is history. Maybe the Australian specialists are better, who knows, but at least for me the outcome was excellent.

In the washup one can only do what they think is correct, life is a lottery I suppose, but in this case one has to do their homework with the specialists and get multiple opinions, which I did.

You say where are the stats, seriously that is a pretty open ended comment. Humans by nature only tend to complain when things go wrong, and this is what this forum is about, not necessarily to complain, but to discuss.

Probably this procedure happens hundreds of times a day here in Australia and a lot more world wide, not everybody knows about this place, for sure, but those who do have obviously done a search and came here to discuss issues. As you well know there are also a lot of people here like myself who have had successful outcomes.

Quite inflammatory to bring in the ideas of trusting surgeons though, yep there probably are some who should not be doing it as they are almost certainly not qualified, but the broad percentage do not come under this banner.

Just my 50C worth.

Not referring specifically to you Peter....there are plenty of others who say the same thing as you. I havent

had any experience of of them yet but i have had plenty of experience with urologists and i wouldnt give you two bob for any of them. ive had dealings with many of them and i have respect for none of them. this particular thread is not the place to discuss urologists however so i'll leave it at that.

i dont have the blind faith in medicos that you have.

I don't have blind faith, as I know that some are absolute shonks, but those that I trust yep, I will let them have a go at me, as they have the track record. My ortho has done 6 procedures on me on most parts of my hands and shoulders, and he is seriously good at his craft. I can really understand where you are coming from, as I said the surgeons knife is the last resort, as it is permanent. If like yourself I found that something non surgical had worked for me, I would have kept with it also, as I have had enough operations in my lifetime.

I am waiting for something that gives me back my taste buds and saliva glands, as radiation has totally destroyed those functions in my mouth. But that is another story. Incidentally my Ortho is the Brother of my ENT who removed my tongue cancer, definitely a family concern.

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As I stated in my reply above to caringbah, the vast majority of people on here are here because they have had an issue, there are also people like myself who have had an excellent outcome. Not sure where you are situated, but it is well worth getting other opinions, and ensure that you are dealing with a professional orthopedic specialist, not someone who just says he can do the job.

Every person is different and every problem is probably also of different intensity. If a joint is very diseased, it will obviously be much harder to fix than one that is in better condition. I know my second thumb was much worse than the first as 12months had passed since the first op and the deterioration in the second was quite advanced. My surgeon said it was a mess and it may take longer to heal as he had to do a significant amount of repair work. In actual fact I believe it got better quicker than the first, so that is confusing as well.

For those that opt for alternative treatments, go for it, but in my opinion they are just delaying the inevitable, but that is just my personal opinion, if it works, I am happy for them, because the surgeons knife really is the final straw.

You don't hear much about successful outcomes here for obvious reasons, people are happy with the result, and that is fair enough. I cop flack because I am happy with my personal outcome, and it is perceived that I am extolling the virtues of the procedure, I am not doing this at all, just passing on that the procedure does work when done by a properly certified specialist, with the caveat that in any operation, things can go wrong, that is just a fact.

If you are in any doubt at all, do not have it done. That really is the final line.

One thing is for sure do not let yourself be conned, get multiple opinions.

Just another 50cents worth!!

Peter, i guess its the consequences of an unsussesfull outcome that are just too horrible to contemplate. Imagine being stuck with more pain than you started with for the rest of your life?

Absolutely spot on, I must admit that thought did occur to me, but I rolled the dice as it were, based on my specialist having worked on me before and advice from my mate's son. At that point in time my thumbs were agonising and I guessed it could not get any worse by having the procedure. It is something that one has to wrestle with based on the individual circumstances. Potential pain against potential gain.

Well finally Peter we are in agreement. 😃

Don't think we ever really disagreed, just came at it from different perspectives.

😉



I hear you Rodann25!

I am scheduled for 11/21 or 11/28 depending which surgeon I choose! It is so scary since I am a dental hygienist and my dominant hand is my livelihood . The one guy is one I have seen for years but he is 76 which makes it a bit scary. The other did my friend's thumb and she had a rough time but is ok now. We never know why,surgeon,pat., situation, pain tolerance????? The younger guy uses the whole fcr tendon,older guy splits it and uses part. I am missing the palmerris so keeping part of the tendon sounds better. Any feedback on that???? 10-14% of people are missing the palmerris.

Thanks!

Very difficult decision isn't it? I spend my days evaluating my thumb usage and pain tolerance to see if it really must be done, I'm not on pain medication at present but its very annoying and stabs of pain buttoning shirts, opening jars, turning pages etc. brings it home many times a day. I do know its not going to get any better by itself, just wish there was another less brutal surgery available and the outcome was a bit more dependable. I'm not sure about the palmerris, Iwill have to do more research.

Roger

Rodnann, why dont you try PRP injections first? I'm only at the beginning of my course of injections and am relatively pain free at this stage. It takes about 40 minutes and you just walk out the door.

Have you tried Arthritis Compresssion Gloves? these gave me immediate pain relief.

Kate, who posts here is getting 5 months between injections.

I had CMC arthroplasty with tendon reconstruction (LRTI) on October 2, 2018. I have had almost no pain after the first 24 hours. The pain that I do have lasts a few seconds, just a few times a day (and becoming less each day), and is not nearly as bad as the pain before the surgery. In fact the old pain is. completely gone! I had surgery on the right thumb (I am right-handed). After reading these boards for 8 months I was expecting a lot of pain. That never happened. I am extremely happy with the results. I had a soft cast post-surgery for 2 weeks, then a hard cast for 2 weeks. The cast was replaced by a very small black neoprene splint. I started physical therapy 2 days later (last week). I will have PT for 6-12 weeks, depending on how well I do. I am doing exercises at home 3 times a day, using heat beforehand and ice after. I massage the incisions with vitamin E oil before I apply the ice to prevent scar tissue from forming. It takes me about an hour each time. I am seeing progress daily and am very happy! I will do my left thumb next February or March. I think a big reason for my excellent results is that I found an excellent surgeon who has done thousands of these surgeries, several every week. I had to drive over an hour to get to his surgery center, but it was worth it! As someone said on these boards, people with complaints seem to post more often, so I just want those of you who are considering this surgery to know that many of us have had excellent results. Take time to find an excellent surgeon. Good wishes to you all!

Well, said, this is the experience I have had. I know some people get nightmare results, but the chances of this happening in my opinion are greatly reduced if you get a fully qualified specialist that has lots of experience in this procedure.

I tried to post a "thumbs up" emoji in response to Peter's comment.

cheers

may I ask who the surgeon is and where he is?

My surgeon is in Santa Barbara, California. Are we allowed to name doctors on this board?

Hi,

I did have 2 cortisone injections, first very successful, the second not so much. I realize the PRP injections are completely different but don't know of anywhere I could get this done in Ontario Canada, will research.

I have tried several types of thumb braces, most didn't work or made my thumb very weak after removing. I have never seen compression gloves.

thanks for the suggestions,

Roger

Thanks Nancy, its reassuring to hear about your experience, please keep us updated, I believe I have a good surgeon, just feel I am rolling the dice with the outcome.

Roger

HI Rodann, PRP is becoming increasingly common. If you google sports physicians you should be able to find someone. Theyre even using it for erectile dysfunction ....dont ask . lol.

I too had cortisone shots and like you they worked first time and then nothing.

Youre right PRP is completely different. Im having shots in my knees in 10 days time for arthritis behind thd patella. im planning a five day hike in December...hoping the shots will make it more comfortable for me.

I think it will pay off for you to try the PRP before surgery.

Nope, the post will not be allowed, apparently naming etc is definitely a big nono

HI Rodann I know you are nervous about playing the guitar afyet surgery. I drove myself crazy trying to make a decision. I needed to do both thumbs but decided to do the right on Aug 28. Had the trapeziotomy and the appologis longis tendon transfer using part of that tendon. It is 9 weeks out and i have no problem fingerpicking and strumming guitar. I have been doing all the pt but I am still having some pain not horrible but there. I can do almost everything but using a pen seems to aggravate it. Strength is getting better and i see doc nov 22. I'm an xray tech and will go back to work after the 3 months. Hopefully the pain will completely gone by then. But again guitar is great. Will do the left but next spring. So as you know your left fretting thumb needs more strength. But I know i will need to do this as it wont get better on its own. I Love my ortho and trust him. Please keep me updated on your progress. GOOD LUCK!Any other questions ill be happy to answer if i can.

Is this a new policy Peter? You used to be able to name your doctor or reccomend doctors.

I was under the impression that the naming of institutions was banned and the associated specialists, may be wrong, but it is best to be safe and just PM people with names etc I reckon.

Hi Rodann....my comment was a little confusing. I meant that you should try the non invasive, 15 min recovery time PRP before you consider surgery.

cheers

I had my 3rd set of PRP injections last tuesday . Right now my right hand is pretty damn good ....about 98% .

My left hand is 80-90%. Both hands used to be about 20%.

Next set of injections will be in around 3 months if all goes according to plan. My doctor is Dr Mathew Hislop of Hawthorne, Brisbane.

Im pretty happy so far...no fuss, no recovery time and a pretty good outcome...so far.