Pyrocarbon thumb joint replacement

Posted by var122 @var122, Jan 15, 2018

I do not know anyone who has had a cmc thumb joint replacement....anyone have any insight? I am 5 days post op.

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@mihalcin

Thanks for your help. He has been to a few hand doctors and been through steroid shots. Unfortunately, they are not working well anymore. He is looking for the best option for his thumbs and that is why we are looking for input from those with experience. We are looking for a surgeon and he is willing to travel to get to someone good if that's the best choice. Thanks.

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Hello, I thought I would weigh in here with my experience. I have had CMC repair on both thumbs due to severe osteoarthritis. The docs both used the "tightrope" procedure for the repair, with great success. The damaged tissue is removed, and the area is stabilized with a synthetic monofilament of some sort and 2 surgical staples to hold everything in place while it heals - scar tissue fills the void where the bone was removed. You get near 100% mobility and about 60-80% strength after healing. I am able to garden, paint, sew, lift even 35 lb grandchildren)... Healing time is shorter than the older "anchovy" procedure. Diligent PT, including at-home exercises, after surgery are the key to successful recovery.
I would caution against waiting too long - my friend did that, and ended up having to have the joints on both thumbs fused because they collapsed from bone deterioration.
Sue

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Thank you for your info. We appreciate your opinion. Looking to make the best choice so hearing people's experience with different type of surgery is great.

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Two years post op pyrocarbon cmc replacement

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@notmybestthinking

Two years post op pyrocarbon cmc replacement

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Welcome to Mayo Connect. We are a community of people living with a variety of diseases and challenges who try to help one another by sharing our experiences.

I am sorry to hear you are dealing with this situation in your thumb - it sounds similar to when I had a failing hip implant and the surgeon kept putting me off - turned out it was recalled, and I ended up with revision surgery and part of a class action lawsuit. When I asked about carbon replacement 3 years ago, my hand surgeon was adamant that it was not yet a proven success and he wasn't doing it. In addition, he felt there is not enough bone in a small hand for successful securing of an implant. It looks like that's what you may have...

If he is part of a group, you could appeal to their Director of Practice, or contact the hospital or surgery center with which he is affiliated to get some response.

Sue

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Thank you for your info. We appreciate it.

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@sueinmn

Hello, I thought I would weigh in here with my experience. I have had CMC repair on both thumbs due to severe osteoarthritis. The docs both used the "tightrope" procedure for the repair, with great success. The damaged tissue is removed, and the area is stabilized with a synthetic monofilament of some sort and 2 surgical staples to hold everything in place while it heals - scar tissue fills the void where the bone was removed. You get near 100% mobility and about 60-80% strength after healing. I am able to garden, paint, sew, lift even 35 lb grandchildren)... Healing time is shorter than the older "anchovy" procedure. Diligent PT, including at-home exercises, after surgery are the key to successful recovery.
I would caution against waiting too long - my friend did that, and ended up having to have the joints on both thumbs fused because they collapsed from bone deterioration.
Sue

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Hi Sue, my name is Jeanine. I saw that you had a tightrope procedure with good success. Can I ask what made you chose that over the "anchovy procedure?"

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@geminipt

Hi Sue, my name is Jeanine. I saw that you had a tightrope procedure with good success. Can I ask what made you chose that over the "anchovy procedure?"

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Jeanine -
I consulted at length with my hand surgeon about my general health, stability (a big concern due to extensive bone loss), recovery time, and lifestyle questions (I do a lot of gardening, sewing, painting & childcare.) We decided the tightrope was the best option - increased stability, shorter recovery. I had the first one done 3 1/2 years ago, the second 8 months ago. Each time I was only totally immobilized for 2 weeks, in a hard splint for 6 more weeks, then as needed. I started hand therapy at 4 weeks and did exercises for a little over 4 months. Sue

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I have seen 2 hand surgeons and one is recommending the tightrope procedure. The hand surgeon at the Mayo Clinic is recommending to avoid that procedure and to have the LRTI with suspension. I have researched the LRTI and found that you lose strength and function and have shortening of the thumb. Those are not the types of outcomes that I want, so now I am leaning back toward the tightrope procedure even though the hand surgeon at the Mayo Clinic said it has a high failure rate. I am a physical therapist and my hands are my life. If you don't mind me asking, where did you have your surgery?

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@stoney

My implants were done by a non-Mayo hand surgeon from Marshfield WI (Steven Sanford). The implant is called Stablyx but I would recommend the Biopro implant because it is more of a ball and socket. With the Biopro, you're getting two brand new surfaces, free of arthritis and defects. The Stablyx only provides a new "ball". I am coming up on three years for both thumbs. They healed equally well. Strength is 90%. I have permanent, low-grade numbness in both index fingers. I'd do it again but with Biopro. I'm 62. The Mayo Clinic system is amazing and by far, my first choice for all major surgeries. I had prostate surgery about a year ago and Mayo treated me extremely well. They have nice hotel accommodations attached to the clinic so you never have to even go outside. Dr. Steven Moran M.D. is a good first option for a hand surgeon. I can help you more with the info if you need help.

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Hi, I am looking at the LRTI procedure by a hand surgeon at the Mayo Clinic in Jacksonville. Can you tell me, did Dr Steven Moran do the Stablyx on your thumb?

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@geminipt

I have seen 2 hand surgeons and one is recommending the tightrope procedure. The hand surgeon at the Mayo Clinic is recommending to avoid that procedure and to have the LRTI with suspension. I have researched the LRTI and found that you lose strength and function and have shortening of the thumb. Those are not the types of outcomes that I want, so now I am leaning back toward the tightrope procedure even though the hand surgeon at the Mayo Clinic said it has a high failure rate. I am a physical therapist and my hands are my life. If you don't mind me asking, where did you have your surgery?

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I had it at Twin Cities Orthopedics in Minnesota - I asked my hand therapist (almost 20 years of experience) about what she sees - she said she has seen one failure of the tightrope due to a fall, and one due to a construction worker returning to work too soon, out of 100 or more tightrope patients she has helped. She called it comparable to the anchovy failure rate.
Sue

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