Anyone have experience with suspension arthroplasty for CMC joint?

Nov 30 had cmc surgery the hand surgeon took the bone out cut one of my forearm tendons to put in place of bone I had asked him about joint replacement and he said (he is young) that they were not taught that procedure in school because of the high percentage failure rate. It is a long recovery and not everyone needs therapy after. I went to 6 weeks therapy to strengthen before surgery. I am in therapy now for desensitization as the area still felt like a skinned knee working well and my strength is improving. It’s a little more complicated for me as I have a reverse total shoulder and it all works together. So nice now I have no pain when driving or sleeping at night.
Glad I had it done. You can watch the surgery being done on you tube, I did that prior to surgery. Developed some tendinitis a few weeks ago so they said I did too much too soon, but very careful now to follow therapist instructions and things are calm again.
Really didn’t require pain meds just took twice post op just to me felt like I fell and skinned my knee
Good luck

There are a number of alternatives to this surgery. LRTI (Ligament Reconstruction and Tendon Interposition) is what you refer to as suspension arthoplasty. Another is Tightrope, same as LRTI except they don't use you fcr tendon, but instead use this "cord" material to suspend the thumb cmc bone from the index finger metacarpal bone. Another yet is Speed Spiral (Stanford University) where the also put a biosynthetic cushion in place of the trapezium. All three of these relieve you of pain, but you will likely loose pinch strength (so I was told by several surgeons in my area). Bio Pro leaves the trapezium in place, but it is drilled out to a ball joint with an implant in the thumb cmc bone. Similar is Stablyx, the trapezium is left in place, and a "C" shaped insert is used to wrap around the trapezium. I had the Stablyx implant done, got my pinch strength back in about a month, and fully healed in 6 months. I am very happy with the results, since pinch strength is very important to me (I am a woodworker). Not everyone is happy that they had the Stablyx implant, but I believe that continued hand strengthening exercises are key to success in any of these procedures. Do your research, and good luck!
GregV

@susanders, in addition to the helpful responses you've received from @gregv and @dmk, you may also be interested in these related discussion and tips shared also by @sueinmn and @artscaping

– CMC Arthroplasty with STABLYX Implant: https://connect.mayoclinic.org/discussion/cmc-arthroplasty-with-stablyx-implant/
- Thumb arthritis: Did anyone have carpometacarpal (CMC) surgery? https://connect.mayoclinic.org/discussion/thumb-arthritis/

What criteria is tipping your decision towards suspension arthroplasty?

Enormous gratitude for your post to me. Tipping me toward suspension arthroplasty: no hard cast for 5 weeks, more rapid recovery, same outcome as LRTI or other. I have confidence in the surgeon who would perform suspection arthroplasty. His reputation was confirmed by another reputable hand surgeon who does LRTI and casts for 5 weeks. Other hand surgeon said different surgeons learn different techniques and typically go with what works best for their patients. He said he knows the other ortho and would feel comfortable having surgery with him. Does that make sense? What am I missing in my decision?

As someone who has stumbled across this board in my 5th week of a cast having had LRTI, I am glad you took the option. I am in pain and doubting this surgery.
Wishing you well.

Hello
I had the LRTI and am currently 5 weeks out. Very painful. I would not advise this procedure.
Wishing you well.

Cathy -
You will be amazed how happy you are when the pain is gone, and you stop dropping things. Regret and doubt after surgery, especially one with a long recovery like this one, are normal. Most likely the pain you are still feeling is because you are constrained in the cast. Are you still using ice & elevation to keep the swelling down?

Your procedure will most likely be as successful as the suspension surgery - just a longer, slower recovery. Hang in there - it will eventually get much better. Just be sure to do your therapy faithfully 2-3 times a day as recommended when they "release" your from the cast.

Feel free to come back and chat as your recovery progresses.
Sue

I use my hands a lot cooking and gardening. In my late fifties, I developed severe pain and loss of function in my left (non-dominant) thumb. In 2014, my excellent hand surgeon removed the thumb bone and replaced it with one of my forearm tendons. I remain thrilled with the surgical outcome — regaining function and strength and eliminating pain — nearly a decade later. My left forearm is hollowed slightly from the tendon reposition, but, for me, worth the risks associated fabricated implants.

Thank you, Sue for those kind words of encouragement. I have tried to use ice, but since I am wearing a wrap, it doesn't seem to penetrate the covering and provide comfort. I do elevate whenever possible. My surgeon says I must be doing too much to cause this pain and I need to baby it more. I feel that I am following the protocols accordingly.
I wish he was a bit more sympathetic to my concerns. I was not fully aware of the length of time required for this healing.
Glad to have found you here and I appreciate your help.
Thanks

Cathy - My daughter was in a huge wrap/cast for 8 weeks following a broken wrist 2 years ago. What we found for icing was 4 very large refreezable ice packs (10x14 or more) - alternately used and rechilled for at least 4 hours - we would wrap it around the cast, then wrap a hand towel over it to keep cold for as long as possible.
I also find comfort from the packs that come with my husband's meds - resting a wrapped joint on one, placing another on top and wrapping the whole in a towel.

I once asked a surgeon "How many orthopedic surgeries have you recovered from?" when he told me I was being a baby. The look on his face was priceless - but I thought he was going to throw me out of the hospital room. The nurse had to turn away so he wouldn't see her trying not to laugh!

Hang in there!
Sue