Hello Richard, and welcome to Mayo Connect. We are a community of people, living with a variety of diseases and conditions, who try to share our experiences and help each other on our journeys. We are not medical professionals, hence we do not give medical advice.

I am a now retired female, very active seamstress, gardener and involved grandma who has had CMC repair done on both thumbs. At my age, I also have a great many friends who have had the procedure as well. So I will share some of that.

Based on the experience of friends, and on previous hand and wrist surgeries, I knew I needed to find and experienced hand surgeon, who does many CMC procedures and uses more than one technique. I did this by consulting with my trusted hand therapist and hip surgeon to see who in our area had the best results and reputation. You obviously have had the advantage of watching the surgeons in action.

I had each thumb done when it was at about 50-65% and steroid injections didn't help any more. The doctor cautioned that if I waited longer, I was in danger of requiring complete fusion surgery. This is the first thing to discuss with your hand surgeon. I had two friends who didn't believe me, waited until the joints collapsed, and ended up with full fusion and limited use.

The first surgery was 2 1/2 years ago, the surgeon explained 3 techniques, the traditional "anchovy" using tendon from my arm, "tightrope" surgery using two anchors and a nylon(?) tightrope to keep everything aligned, and using an introduced blood clot in place of the tendon.
He recommended the "tightrope" as having higher success and a shorter healing time. I was at 65% 8 weeks post surgery, 80% at 3 months. I was back to sewing and tending toddlers after 8 weeks. Occasional swelling occurred with overuse for about 6 months. I now have full use of that hand, but haven't tried doing CPR!

In June, I knew the second hand, my dominant left needed to be done, and I was as at maybe 50%, and found a new surgeon (the first, most excellent one moved away.) I asked about an implant because a friend had gotten it, and it seemed successful after a year. As a petite female with advanced osteoarthritis, my hand surgeon told me he would not consider Stablyx implants because they are (his word) finicky and he felt I didn't have enough bone for successful fusion. We again selected the tightrope as the best method, his placement of the pins and tightrope was a bit different than the first, and at 6 months I have 90% recovery on that hand and better range of motion than the first, with no pain or swelling.

I have spent much of 2020 sewing (masks and quilts) manipulating large swaths of fabric and using rotary cutters extensively with this new repair, and can say it was a success. After observing numerous friends have the CMC repairs with varying success, I believe that no matter which avenue you choose, the key is faithful PT/OT to recover use and strength. My friend and I who were diligent have few if any limits to what we can do. Others who were less so have more stiffness, pain and weaker grip.

Side note: With properly functioning thumbs, arthritis pain has subsided in my hands a bit as I am using them correctly again, not always trying to compensate for the painful, useless thumbs.

I wish you luck with whichever option you choose. If I were considering Stablyx, knowing it can fail, I would ask the surgeon what my options would be if it turned out not to work..
Sue

As long as you have time on your side, keep researching this topic. There are many options to consider and your situation at work seems to be the biggest consideration. I found this video on YouTube interesting, dealing with a BioPro prosthetic implant. YouTube has video testimonies which I found to be helpful as they relate to some of the issues I was facing. I am 62 years old and just turned the 3-year corner on my left thumb, Stablyx surgery.
https://www.youtube.com/watch?v=OaVEb8xzG80

Hello Richard,
Shamu here. I am only a common 61 year old who has worked with my hands all my life. Now not anything like you do though. I am currently still employed and I do shipping and part inspection and identification in a large machine /model shop and use my hands every day doing everything from using small tools to placing small parts in small zip lock bags. Zip lock bags suck! The small 3 inch ones kick my butt when I have hundreds to do. That thumb on forefinger slide job still irritates the joint. I had my right hand done with the Styblix in May 2019. I had my left hand done in November 2019. No regrets in my case. That being said, I am my own boss for the most part and anything I can't do myself, I found help from others in the shop to help. I have documented my two events earlier in this thread.

It's been 18 months and my right hand is doing real well. I have been using all my experience from the right to deal with bringing along the left. For me and my situation I made the right choice. I feel at the 2 year mark I will be at the advertised success rate of having a 95-98 % use back with some manageable slight pain issues. I never expected 100% recovery. We as a race can never match the creators product.

Can I live my life normally now? Yes. Do I notice issues? Yes. Do my hands work as they did 20 years ago? No. Are they as nimble? No. Do I have any pain? Yes. Is this pain manageable? Yes. Do you see where this is going? Lol.

No one here can tell you what you should do. There are several types of replacement joints discussed here. Most seem to be successful. Most seem to depend on you, the surgeon and your mindset and efforts in the rehabilitation efforts.

First go here and watch this video. https://youtu.be/RKApgiazfXw

I'm gonna catch flack for this comment. Do you trust just anyone to do this to your hand? I wouldn't. Just because my buddy rebuilds motors for Ford's and Chevy's, am I gonna let him rebuild my 1959 Ferrari motor? HECK NO! I'm gonna get the Ferrari guy. Not that my buddy couldn't do the work and that the motor would run, just that the guys that do the Ferrari motors know every little trick and know those little things that make them THE FERRARI MOTOR GUYS. LOL.

I feel that I was very blessed that I found Dr. Vo who did both my surgeries. He has done over 100 styblix implants with ZERO failures. Another person here, Wally, he found another surgeon before he found Dr. Vo. The other surgeon he looked at had a 40% failure rate on the 10 stablix joints he installed???? Sorry, that Chevy surgeon ain't working on this Ferrari. Lol.

Richard, no one can predict your best option. Can you plan on going back to your job doing what you do now as you do it now? Well I was able to do mine with changes how I went about it. Do you have this ability or option available to you? These surgeries in my case we're life changing for the better. Did I have to make changes how I do things? Yes. Would you abilities change? Yes. For how long? I say 90 days at a minimum to have fair use back. 2 years for 100% is predicted. I concur with that.

Richard, there are some things I do that make my hands hurt, one is making a fist and pounding on something. It hurts. Pushing my Jeep in the garage to re position it while working on it causes pain. Pulling hard can cause pain. Now it's bearable but it happens. Push ups suck. I don't do them. I never did them anyway so that was a bad example! Lol. Some movements will never be the same. I accept that. My life is better than it was.

Shamu .......