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CMC (carpometacarpal) joint surgery: What outcomes can I expect?
Bones, Joints & Muscles | Last Active: 4 hours ago | Replies (26)Comment receiving replies
Hello,
I was told that I have Thumb arthritus in both my hands which would require re-constructive surgey. My left (dominent) thumb is not functioning like it did. Example: Not being able to bend my thumb properly to send text messages. My thumb clicks like a broken cabinet hinge to straighten it out. They explained the LRTI procedure which just seems pretty radical to replace a bone with some cartilage to regain stability and reduce pain. I am concered that if I go through with this procedure, I may not be able to use my thumb again for things like: playing guitar to grip the neck. golfing, bowling, labor intensinve work and general gripping.
1. Can someone please tell my their experience and whether this surgery will allow for me to continue doing the things I love?
Will I be at 100% functionality again?
2. Also by removing some of the tendon from your arm, do you lose strength and mobility from your arm?
3. Also how long can I expect to be disabled (i.e., recovery process before resuming normal tasks with my hand and thumb?)
Sorry for asking so many questions, but just concerned is all.
Thank you!!
Replies to "Hello, I was told that I have Thumb arthritus in both my hands which would require..."
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@jokish Unlike @dmk, my hand surgeon was insistent on therapy by a qualified hand therapist (this is a specialty for either a physical, or more usually occupational, therapist.)
Before surgery, you may want to check into the exact procedure - there are several types of CMC surgery. In my case, I had what is known as CMC suspension arthroplasty without tendon transfer (sometimes call the tightrope procedure.) This was done on both hands, one nearly 20 years ago, the other 6 years ago. Both are still functioning perfectly and without pain.
The trapezium bone (cause of your pain) is removed. A small "cable" between the metacarpal bones of the thumb and first finger is inserted to support the joint as it heals. Scar tissue forms naturally where the bone was removed. There is no second surgery site or tendon stripping, and no waiting for the tendon to heal in. This cuts down on the immobility time for 6 weeks to 3-4 before you begin strengthening therapy and moderate hand use. Total recovery time is individual, usually 3-5 months, with longer to regain full strength.
Outcome for me - no pain since the post-surgical pain. Able to do everything I could before including lifting, carrying, holding and using tools, gardening. I have some moderate loss of pinch strength, but am average for a 75yo female. I have good grip strength - now that they have also replaced my arthritic wrist I can even open tight jar lids. Range of motion is better than before surgery.
Like may other orthopedic procedures, this recovery is not "automatic" - you will need to do mobility and strengthening exercises daily for three months or more, but they can be done at the kitchen table while you have your coffee.
PS A couple friends who play guitar have had this done, and were told playing is good therapy.