CMC Arthroplasty with STABLYX Implant

If you see changes (ask her to put the x-rays up side-by-side for comparison) and think surgery is in your near future, you may want to skip the shot and go to a hand surgeon. After an injection, surgeons make you wait anywhere from 6 to 12 weeks for a procedure. You may want to read about "tightrope" and anchovy CMC procedures and the Stablyx implant before you choose a surgeon, then make sure the one you find does the one you prefer.

Good luck, and let me know what you plan to do next.
Sue

In reply to @sueinmn…sry for the long delay. Xrays indicated continued deterioration to moderate stage in my left thumb joint. I explained my symptoms (I believed thoroughly). Rheumatologist eventually said I was a candidate for surgery whenever I felt it was time….stating it was a fine line when to proceed….gave me no direction….offered a shot, but I am not going to follow up with her at this point. In fact, idk what I will do. After much prodding due to ongoing spinal pain she agreed to xrays, which showed more deterioration in the lumbar region and she was unable to answer many of my questions that I thought were not that difficult. After she reviewed my spine doctor’s notes from Mayo, she agreed to a follow up MRI, which also showed deterioration in more ways than the xrays that she originally thought the MRI would not. I have an appt at Mayo in October and I convinced her to refer me to PT. I will confer with the spine doctor for a continued care provider in this area as I am done with her. We have no other options here, so I will continue to communicate with her until I eventually fade away to someone who will play an active role in my arthritis care (DDD). Obviously, driving long distances is a way of life for quality healthcare when a person lives where I do. Otherwise, one hopes to stay healthy! I am very blessed to be okay, upright, walking and managing. I feel so much for others’ struggles and always wish they can find relief and solace. There’s my long answer to your request to “keep you posted”😂

If I remember correctly you are in Northern MN? I have a friend in the Bemidji area, I'll try to find out who she sees if you wish. Like you, she is very proactive about her health care, and selective about providers.

As for the thumb, all I can say is "you will know" - just don't wait until the joint begins to visibly collapse, or to "lock up" (indicates it is fusing on its own) - then fusion becomes the only option. And be sure to have a hand surgeon do it - it can be done well or not so well, and experience really matters.
Sue

After multiple steroid injections to both of my chronically painful thumbs I had both right and left thumbs, respectively, repaired with the Stabylx implants for CMC arthritis graded at 3 1/2-4 with adequate in situ trapezium bone health (a requirement for this implant type) No other significant arthritis of either wrist. Surgeon hand specialist recommended the Stabylx implants. The first (Rt) in Aug 2020, the second (Lt) in Nov 2020. The recovery process is ongoing at this comment date. The recovery process is slow and arduous to be perfectly honest. Doing your daily therapy is vital for return of function and range of motion. Morning stiffness and pain is the norm at this point with the right thumb (10 months post op) less painful than the left (7 months post op). The morning pain and stiffness decreases for me with stretching exercises to a degree. I am still using ice when I overdo activity that causes pain. I am retired from healthcare so I am fortunate that I can gauge my daily activities. I avoid pain meds (generally never more than 1Gm of Tylenol/day) so that I can accurately assess my healing progress. Certain motions ( ie; buttoning pants, sealing a zip lock bag, squeezing a toothpaste tube) still cause sharp pain in the left with a much duller, pressure type of pain in the right. My hope is that it (pain on the left side) will decrease or become less acute over time. I received a steroid injection in the left thumb after a visit to the surgeon about a month ago in May, (6 months post op)for the continued left thumb/wrist pain and was told a revision may be necessary on the left. The steroid injection definitely helped. I’m posting here because this is the only forum I’ve seen that discusses this particular implant in depth with real patients discussing real issues. As far as strength is concerned the limiting factor to the pinch grip strength is how much or how little pain that it causes. My right is less painful so therefore much stronger than my left at present (currently at about 90% of pre op strength). Hope this post helps someone struggling with a decision to choose a surgery option. Any commentary by those who have had this procedure that are farther along in their recovery process would be greatly appreciated. Best wishes.

POD#4 Pain level has subsided from immediate post op rating initially of a 8/10 rating to 5/10 today. Post op dressing obscures seeing much below the fingers and a little bit of the knuckles. Definitely swollen and mildly red. Flexion and extension of the fingers is possible, mildly painful and recommended to decrease the swelling. Elevation maintained almost constantly. Using ice regularly for 15 min at a time on the 3 most painful areas frequently throughout the day. Painful areas are; dorsal hand, radial wrist/forearm area at base of the thumb, and anterior forearm. Hoping for better results with this procedure than I had with the Stablyx implant which was a disappointment and a very painful experience for 10 months.I do not recommend this implant because of its documented history of continued problems with the flange portion of its design and my own personal experience. It may work for others but that has not been my experience. I hope this helps anyone who is trying to make a decision between available solutions to this painful basal thumb cmc arthritis condition.

I hope you are seeing less pain and swelling each day.

When sitting I often used a large gel wrap around the entire wrist and forearm, secured with a velcro wrap. Also, I was most comfortable when I continued to ice for several weeks, especially after daily therapy.
Sue

Hi and thanks for your comment. On post op day seven and now down to 2 ES Tylenol/day (1 in AM and 1 in PM). I have a similar icing routine to what you described and it is very helpful with the swelling. I see the surgeon on Monday so will post when I get the scoop on what went wrong with the Stabylx implant.

Stabylx Revision Update. About 4 weeks post op today. The experience of the Trapeziectomy w/ Arthrex mini-tightrope procedure has been very positive. Stabylx implant was removed and for the most part all the pain that was associated with that implant is finally gone. What a relief! The only pain I’m experiencing at this point is normal healing process stuff with the incision and some associated normal post op tightness with the APL tendon transfer. (apparently my FCR was absent when the surgeon opened me up- that’s a whole other post) Still using a OT (occupational therapy) rigid splint (got out of the post op splint after 10 days) with the option to take it off for, dressing, bathing and very light use or just resting. Could not be more pleased with the results of this revision as of this date. Highly recommend the Trapeziectomy w/ Arthrex mini tightrope procedure for advanced CMC arthritis related repair.