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Thumb arthritis: Did anyone have carpometacarpal (CMC) surgery?
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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@marysara1 Have you considered carpal metacarpal (CMC) surgery? As far as I know, it is the only real cure for the bones rubbing together.
I have both osteo- and rheumatoid arthritis, abused my hands for years with gardening, sewing, typing, remodeling, etc.
The only successful brace I found was a custom one of moldable plastic made by a hand therapist. That, along with steroid injections, kept me going for about 3 years (I think) but finally, surgery was the only solution.
The CMC surgeries were life-changing (one over 10 years ago, the other 6), though the recovery was longish - 8 weeks to daily use, 6 months to full strength.
Once the wrist was immobilized after surgery, the rest allowed the inflammation in the carpal tunnel to heal on its own.
I chose a highly recommended & qualified hand (plastic) surgeon, and faithfully did the PT for months. My doctor used the "tightrope" method, which did not require a second cut to harvest tendon material, and a second site to heal.
Have you considered CMC surgery?
PS I am currently recovering from a total wrist replacement - arthritis destroyed that too, and the earlier patch - called a carpectomy, failed. My kids started calling my hands "bionic."
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1 Reaction@sueinmn My renowned hand surgeon confirmed that I have carpal tunnel syndrome and arthritis at the base of the thumb in each hand. he told me he had to do two operations, one on each arm, and release two nerves: one in the wrist and one in the upper arm. And he told me he had to do both under general anesthesia.
I am an 81 YO male and I fear general anesthesia. I am also not fond of the recovery time for the surgery. In just under three weeks I have an appointment with Shelley Noland at the Mayo Clinic. I am hoping I qualify for this:
https://www.mayoclinic.org/medical-professionals/physical-medicine-rehabilitation/news/new-approaches-to-carpal-tunnel-release-and-treatment-of-tendinopathy/mac-20521546
I am not looking for perfection. Just less pain.
@sueinmn Thank you for your thoughtful reply.
I need a total wrist replacement in my right hand - I am putting it off as long as possible:-). I had 2 unsuccessful surgeries in my right wrist. My connective tissue has no integrity, so I am very reluctant to do another surgery. Are you pleased with the replacement?
@marysara1 Funny you should ask. I am 4 weeks post-op, still in the healing phase and in a splint 23 hours a day, but largely pain-free. Just returned from my hand therapy appointment, where she adjusted the splint, did a great massage, and helped me perfect my PT exercises.
One (newer) technique the surgeon used was to remove the most troublesome nerve - the therapist explained a new member of the team brought this to the group 2 years ago, and it is proving to be an excellent addition to the surgery.
Another new-to-me technique, after many hand/wrist surgeries, is lymphedema massage and ONLY using a compression sleeve during daytime hours. My OT is also a certified lymphedema therapist, and she says this allows daytime activity to assist with moving the fluid towards the lymph glands. Switching to a soft sleeve overnight allows the tissue to relax.
I now have the same mobility as before surgery, but with only stiffness, not pain. She expects me to regain 70% plus of full mobility at 6 months, with diligent stretching and therapy.
Her last words were "Let it heal! Stretch and massage only. We will start full therapy in 4 weeks."
So far, so good.
@steveinarizona
Dr. Shelley Noland operated on my right thumb two years ago (I was 77), using the suspension method (two incisions, one a few inches lower to take tendon and use it as part of the fix for carpometacarpal surgery. I did not have carpal tunnel. I had general anesthesia and did well.
Yes, it takes a bit of time. Hand PT at Mayo--on the same floor as her office. They are fully tranied and work on hands (also in that room, have shoulder PT--did that too and more arm related) PT specialists.
My results are good. I am not 100%--have osteoporosis as well as osteoarthritis. Both my thumbs have had surgery--the other for an accident with glass in 2018.
@lr
Thank you. My neurologist whom I completely trust thinks the world of her so I am looking forward to my appointment. I just missed out on a couple of earlier cancellations.