Thumb arthritis: Did anyone have carpometacarpal (CMC) surgery?

Posted by dmk @dmk, Oct 5, 2022

Has anyone had CMC surgery where the trapezium bone is removed and your tendons are knotted to sit in the space to cushion your thumb? If so what was your experience? Thanks in advance

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@alansey

Hello! I had the Stablyx implant (prosthesis) surgery in 2018 on my left thumb. Although I had great hand therapy, I had to get another surgery to "clean up scar tissue" in order to relieve significant pain. To this date, motion is limited, with mild pain. However, if I accidentally bump it, the pain is intense. One side effect I don't like, is the feeling that my thumb is disconnected, for lack of a better term. It's difficult to handle small items, due to the tactile insensitivity. I am a woodworker as well! I believe that because this is a prosthesis, that's the reason for the strange sensation. No phantom pain (bc some nerves preserved), but not ideal.
Fast forward to today, and the wear-and -tear- arthritis of doing things I love, has taken it's toll on my right dominant hand. I've been putting it off, but now, it's time. I have decided to NOT go the implant route and to trust my new surgeon with her 26 years of anchovy experience.
I am curious about the "tightrope" option, versus sacrificing a tendon, as tendons are there for a reason. I've heard good and bad, regarding the anchovy procedire. If you had to get your other thumb fixed, which option would you choose?

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Not @gregv but another who has "worn out" my hands from decades of gardening, typing, sewing, remodeling and arthritis.
I have had both CMC joints done using the tightrope approach, several years apart and by 2 different surgeons. My thumbs continue to hold up today - one is about 6 years old, and the other is 15. They have full sensation and range of motion and good grip strength. I only wish the rest of my hands felt as good.
Why did I choose the tightrope? Shorter healing time and the potential for longer success.
My current shoulder/arm surgeon was surprised I had the surgery from the superficial appearance of my thumbs.

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Thanks for the info. i'm sticking w hand braces

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@sueinmn

Not @gregv but another who has "worn out" my hands from decades of gardening, typing, sewing, remodeling and arthritis.
I have had both CMC joints done using the tightrope approach, several years apart and by 2 different surgeons. My thumbs continue to hold up today - one is about 6 years old, and the other is 15. They have full sensation and range of motion and good grip strength. I only wish the rest of my hands felt as good.
Why did I choose the tightrope? Shorter healing time and the potential for longer success.
My current shoulder/arm surgeon was surprised I had the surgery from the superficial appearance of my thumbs.

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THANK YOU SUE!! I'm going to ask my doc about the tightrope, vs sacrificing a tendon that God put there for a reason. Another surgeon mentioned this to me and admitted that the buttons can break loose, requiring more surgery, but you've had nice results. I know the anchovy procedure has been the standard for a very long time, but the tightrope sounds promising. Thanks again!

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I had that surgery no pain anymore. Surgeon described he cuts a piece of tendon from forearm and wraps it up in place of the bone. Had 6 weeks occupational therapy prior to surgery. Post op is long but in the end worth it no pain anymore. I’m one of the few patients that also required post op occupational therapy, I have a reverse total shoulder on the same arm. Very successful surgery for me with hand surgeon. I also watched a you tube video online of the actual surgery prior to having it done.

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@elisabeth007

Thanks for the info. i'm sticking w hand braces

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My friend did that for too long, and now her only option is a full thumb replacement which has limited success, or fusion of the joints, which would eliminate many things I enjoy doing.
I'd say 15 years is a good, long run for a CMC repair. And for the lack of pain.

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@alansey

THANK YOU SUE!! I'm going to ask my doc about the tightrope, vs sacrificing a tendon that God put there for a reason. Another surgeon mentioned this to me and admitted that the buttons can break loose, requiring more surgery, but you've had nice results. I know the anchovy procedure has been the standard for a very long time, but the tightrope sounds promising. Thanks again!

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Until I tore my rotator cuff, I used to tax my thumbs to the max, throwing disk golf, swinging from overhead bars and climbing with my grandsons.
If you are realistic about giving your body time to heal, I think the tightrope is great - now if they could just fingers....

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Yes, I had that surgery using my tendons to bridge where the trapezium was removed on both of my thumbs; first the right one in 2022 and then my left in 2024. Both surgeries were fairly easy recoveries and were successful. Because the arthritis in my fingers and wrists has progressed further every year, it makes it feel as though the second surgery outcomes have not been as good; but in truth, the pain decreased considerably. I was constant before and I had to wear a brace. Now it is sporatic, more generalized in location and manageable with diclofenac topical (Voltarin).

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@sueinmn

Until I tore my rotator cuff, I used to tax my thumbs to the max, throwing disk golf, swinging from overhead bars and climbing with my grandsons.
If you are realistic about giving your body time to heal, I think the tightrope is great - now if they could just fingers....

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@sueinmn I had my thumb done in 2013. Actually, 2012 and 2013.
It had to be modified twice because my body rejected the cadaver tendon the surgeon used. The third he used my own tendon, and that was good.
However, my thumb would not extend out past my wrist. It’s better now.

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