Anyone have experience with suspension arthroplasty for CMC joint?

Posted by susanders @susanders, Apr 5, 2023

I've seen 3 hand surgeons, and each one has a different process. I like the approach of the one who does suspension arthroplasty. Wondering if anyone can share their experience. I am in Kansas City. Thank you.

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@sueinmn

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

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Love that story. Good for you for putting it back on him. Each person heals differently.
My surgeon has awesome reviews and a wonderful reputation. I have always been pleased with the interactions with the exception of this one. I may mention this on my next visit.
I am off to try the icepack suggestions now.
You are a gem and I appreciate your advice and insight.

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It takes a long time totally heal from this surgery. My surgeon told me "6 weeks". NOT!. More like 6 months! Insist on getting Occupational Therapy after surgery. It will help you regain strength and mobility. Overall, I am very happy I had the surgery in the long run. But don't be discouraged by the length of time it takes to heal.

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@sueinmn

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

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Sue
I had to update you on my status. Today, Monday, was to have been my 7th week with this cast and I was supposed to have it removed today and then move into a removeable cast as well as start PT. Unfortunately, I contracted COVID from my dear sweet husband, and tested positive on Saturday. I started to feel poorly this morning, so I immediately contacted the doctor's office to cancel my appointment. The nurse said she would have to speak with the doctor and get back to me.
She called a few hours later, sharing that the doctor was going out of town next week, so unless I tested negative prior to Friday, I would then have to remain in the cast for 2 more weeks. That would be a total of 5 weeks in this particular cast, and a total of 10 weeks in a cast overall.
I politely explained to her that you could test positive for several weeks after your initial infection. She didn't have a response, but instead said the doctor didn't want to jeopardize his and his staff's health. She then told me to call the office on Thursday if I have tested negative. If so, they would then try to squeeze me in on Friday.
I am beyond trying to figure this out. I can't help but think that spending two more weeks in a cast is an ineffective approach to my healing. That, and not starting PT, could also impair things.
Additionally, not having other doctors (a backup one) who could see me next week would be an option as well, No.
What are your thoughts on this?

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The important thing to remember is that recovery from this procedure is that we are all individuals and our bodies don't all react the same way.
I had the mini tightrope procedure done on 8/1. My surgeon uses the same recover protocol as for the LRTI. He reminded me at the time my hard cast was removed at 6 weeks post op that recovery is marathon, not a sprint.

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@soozy2

The important thing to remember is that recovery from this procedure is that we are all individuals and our bodies don't all react the same way.
I had the mini tightrope procedure done on 8/1. My surgeon uses the same recover protocol as for the LRTI. He reminded me at the time my hard cast was removed at 6 weeks post op that recovery is marathon, not a sprint.

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Hello, soozy2, and welcome to Mayo Connect. You have a wise surgeon for sure. I have had the mini-tightrope on both hands - complete physical recovery was 6 months, full strength at about 1 year.
My new PCP and I just looked at medical records today with, and realized the first repair is 17 years old and still working. She was surprised it has lasted that long - and even more amazed that my grip strength with that hand (measured in PT this summer) is average for anyone my age.
A tiny bit of advice - I do a lot of gardening, hand work, even some furniture refinishing and all the typical homeowner hauling, etc. My OT recommended thumb spica soft splints for moderate exertion, and a hard splint (custom) for really heavy work to protect the joints. I have soft sets everywhere - garden shed, garage, both cars and house, and a hard set in the garage and use them pretty faithfully - I believe that is what has protected me for so long.

Good luck in your recovery.
Sue

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@dmk

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

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I had suture suspension CMC surgery 6 weeks ago. I had a wonderful young, talented surgeon. I left the hospital in a bulky cast, which was removed exactly one week later. I did not need any pain meds, not even Advil. I started PT exactly one week after surgery. I will continue my PT twice a week through the end of this month. I don’t even need a splint now. I am pretty much pain-free with a new hand. I have seen videos of people in a cast for weeks and weeks, still in severe pain. I don’t get it. I’m just glad I’m not one of them. Do your research and shop around for the best surgeon you can find. Do the surgery that you want, not the one that is the only one that a surgeon does.

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@lexie4

I had suture suspension CMC surgery 6 weeks ago. I had a wonderful young, talented surgeon. I left the hospital in a bulky cast, which was removed exactly one week later. I did not need any pain meds, not even Advil. I started PT exactly one week after surgery. I will continue my PT twice a week through the end of this month. I don’t even need a splint now. I am pretty much pain-free with a new hand. I have seen videos of people in a cast for weeks and weeks, still in severe pain. I don’t get it. I’m just glad I’m not one of them. Do your research and shop around for the best surgeon you can find. Do the surgery that you want, not the one that is the only one that a surgeon does.

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Welcome to Connect @lexie4. I am happy to read that you were pleased with your surgeon and I applaud the way you have handled the pre-surgery PT and the post-surgery pain medication. Just a note.....I have had this type of surgery on both hands. It is great to be able to open bottles and play with the grandchildren again.

I will share with you one rather surprising incident. With my first surgery, I was living on a mountain in Southern CA at about 6000 ft. That was a bit too much altitude and the medication did not help so I had to go back down the mountain for a few days. My surgeon also changed the medication. Other than that unexpected event....everything went smoothly.

Is this surgery on your dominant hand?

May you be safe, protected, and free from inner and outer harm.
Chris

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@artscaping

Welcome to Connect @lexie4. I am happy to read that you were pleased with your surgeon and I applaud the way you have handled the pre-surgery PT and the post-surgery pain medication. Just a note.....I have had this type of surgery on both hands. It is great to be able to open bottles and play with the grandchildren again.

I will share with you one rather surprising incident. With my first surgery, I was living on a mountain in Southern CA at about 6000 ft. That was a bit too much altitude and the medication did not help so I had to go back down the mountain for a few days. My surgeon also changed the medication. Other than that unexpected event....everything went smoothly.

Is this surgery on your dominant hand?

May you be safe, protected, and free from inner and outer harm.
Chris

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Yes, dominant hand. That was my only inconvenience!

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Sue, My wife Ruth and I also live in KC, near Lees Summit, and she needs the CMC joint surgery for thumb arthritis. We met with one hand surgeon who only does the traditional LRTI surgery with a long recovery time. We are meeting April 10 with a KU Med hand surgeon who did his fellowship at Duke (Jacob Brubacher, M.D.) where they promote a suspension type surgery that does not involve a wrist tendon transfer and has about much shorter immobilization period. Would like to know your experiences and who did your thumb surgery. Thanks. John & Ruth Mencl

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@johnkc67

Sue, My wife Ruth and I also live in KC, near Lees Summit, and she needs the CMC joint surgery for thumb arthritis. We met with one hand surgeon who only does the traditional LRTI surgery with a long recovery time. We are meeting April 10 with a KU Med hand surgeon who did his fellowship at Duke (Jacob Brubacher, M.D.) where they promote a suspension type surgery that does not involve a wrist tendon transfer and has about much shorter immobilization period. Would like to know your experiences and who did your thumb surgery. Thanks. John & Ruth Mencl

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@johnkc67 , you'll notice that I removed your personal phone number for your security as per the Community Guidelines (https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/). Connect is a public forum and by sharing here in the forum, you are connecting with several people where all can benefit from group support.

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