Bone on bone thumbs

Posted by lioness @lioness, Sep 3, 2018

Is anyone suffering with thumbs Ive had this for awhile , Dr would inject the thumb but now my rheumatologist refused so am seeing a orthopedic Dr has anyone else had this problem?

@cdbell

I have had bone-on-bone in both thumbs with multiple steroid shots for the past three years,but the shots no longer work. Reports on surgical outcomes are varied, even with patients who have found the “best” surgeons. Are their conditions that lead to a better result? A better surgeon? Better OTs? Younger patients? Still Wondering.

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I had both thumbs surgically treated years ago, both are fine now. One was fusing the 2 rubbing bones together with an implanted titanium screw. The other, a tendon was substituted for the offending bone (arthroplasty) and it took a bit longer to rehab. Find an orthopedic surgeon who specializes in hands and get references. I am 76 now. Was in 60's for first one, 70's for second one.

Liked by lioness, dysnotfun

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rlbry, thank you for saying what I needed to hear. Than you for your response. A celebrated Chicago hand surgeon, responding to my x-rays advised that while beyond, braces, salves, heat and cold, and prosthetic devices, surgery was my only option but not necessarily a great one. How long did you spend recovering? And why the two different methods? Of course, I want to find a surgeon who gets it right most of the time.

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Two different surgeons in different towns. Each had preferred method. Was back to full use in about 2 months.

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@pharmd

Seems older posts have disappeared so I'll update my story. I had CMC surgery on right thumb in late October, 2018. I chose the Stablyx implant. I've had a previous implant in left hand in 2009 which has worked great. That implant is not made any longer. I am now able to use my right hand for almost everything! Still doing OT twice weekly. My hand surgeon did 2 dry surgeries before using me as his first patient. I'm glad I did it and I have great confidence in him. Thanks for taking the time to read this.

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I'm bone on bone, wear a brace and I'm having a really hard time performing my duties as a nurse. Since I am currently single I obviously need to work. My ortho wants to do the tendon thingy and assures me a 100% return to mobility but I've heard horror stories about the recovery or lack thereof. I'm hearing good things about this Dr Elhassan at Mayo. Is this where you had your surgery? How about recovery time ? Pain? Thank you in advance

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@nrsinpain

I'm bone on bone, wear a brace and I'm having a really hard time performing my duties as a nurse. Since I am currently single I obviously need to work. My ortho wants to do the tendon thingy and assures me a 100% return to mobility but I've heard horror stories about the recovery or lack thereof. I'm hearing good things about this Dr Elhassan at Mayo. Is this where you had your surgery? How about recovery time ? Pain? Thank you in advance

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My surgeon offered the tendon relocation but I saw several of my Rx patients who were unhappy with the results. Please note my surgeon is in Chicago and I live in a small town in the West. I told him my concerns and since my first implant had been so successful that I preferred the newer implant. And if..a big if…this implant fails for any reason I can still have the tendon relocated. The pain was very tolerable. I did take Rx meds and gradually tapered off to routine acetaminophen. Drawing syringes, adding tubing and similar movements won't be allowed for at least 6 weeks. If I were you I might do my non dominant hand first in any case. If you've heard good things about this particular surgeon I would call his office, set up appointment and get his opinion. You might also ask if any of his operated patients could be contacted (HIPAA preserved of course). From Oct 24 til mid December I obeyed the " no pinching movements" and very gradually increased my use. I can tell you opening my Rx bottles with safety caps was still challenging, these were my personal bottles. It quickly reminded me why both my hands failed after 35+ years in pharmacy. Not sure I would ever be a dispensing pharmacist. But I'm retired so not a problem. Maybe you could ask for light duty after a few weeks of recovery. Hope this helps but probably raised more questions than answers. We're all different so one solution for me may not work for you. Do more homework. Best of luck!✋

Liked by lioness

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@nrsinpain

I'm bone on bone, wear a brace and I'm having a really hard time performing my duties as a nurse. Since I am currently single I obviously need to work. My ortho wants to do the tendon thingy and assures me a 100% return to mobility but I've heard horror stories about the recovery or lack thereof. I'm hearing good things about this Dr Elhassan at Mayo. Is this where you had your surgery? How about recovery time ? Pain? Thank you in advance

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I had an osteo-integrated screw on R wrist, some moderate pain easily managed, back to normal in about 6 weeks. Left wrist was the tendon relocation: splinted with sutures for 2 weeks, then a rigid splint for 4 weeks along with some PT. Overall pain not bad but probably wouldn't have wanted to work (am retired anyway). I sensed some minor loss of strength because of loss of tendon but that has improved over the past couple of years. Bottom line: both methods worked well and continue to serve me well. Hope this helps.

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Any further feedback re the operation? About to have second steroid injection which I’ve put off having for a month or so. Specialist still recommending op as thumb is becoming quite disfigured and now at a funny angle. Although pain isn’t really a problem (more just an ache in the cold weather), the problem still remains with grabbing onto things, releasing and twisting jar lids etc. I’ve been assured by the Specialist the rehab isn’t so bad either – 2 weeks in a thumb brace so as to stop movement and allow proper healing, then 6 weeks in a small thumb brace (similar to what I wear now occasionally at night or when I have pain). I’m thinking now that surgery may be the best thing but still procrastinating as to when that might be.

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@hensy

Any further feedback re the operation? About to have second steroid injection which I’ve put off having for a month or so. Specialist still recommending op as thumb is becoming quite disfigured and now at a funny angle. Although pain isn’t really a problem (more just an ache in the cold weather), the problem still remains with grabbing onto things, releasing and twisting jar lids etc. I’ve been assured by the Specialist the rehab isn’t so bad either – 2 weeks in a thumb brace so as to stop movement and allow proper healing, then 6 weeks in a small thumb brace (similar to what I wear now occasionally at night or when I have pain). I’m thinking now that surgery may be the best thing but still procrastinating as to when that might be.

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@hensyy Left thumb was injected with hylaronic acid back in 2011 it's just now starting to hurt.

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@lioness

@hensyy Left thumb was injected with hylaronic acid back in 2011 it's just now starting to hurt.

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Does Medicare pay for hylaronic injections for hand joints?

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@maryclaire651 It did as I never got a bill . I told my pain Dr about it here . I'm due for a injection in my left knee so I'm going to ask him for that .

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I had the steroid injection under guided ultrasound and my bill was over $300 with less than half of that refunded by Medicare. So it’s quite an expensive procedure. At least there’s no pain for the moment so it seems it’s lasting for quite a few months.

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@hensy

Any further feedback re the operation? About to have second steroid injection which I’ve put off having for a month or so. Specialist still recommending op as thumb is becoming quite disfigured and now at a funny angle. Although pain isn’t really a problem (more just an ache in the cold weather), the problem still remains with grabbing onto things, releasing and twisting jar lids etc. I’ve been assured by the Specialist the rehab isn’t so bad either – 2 weeks in a thumb brace so as to stop movement and allow proper healing, then 6 weeks in a small thumb brace (similar to what I wear now occasionally at night or when I have pain). I’m thinking now that surgery may be the best thing but still procrastinating as to when that might be.

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@hensy, Good afternoon. I noticed that you are considering "thumb" surgery. I let the pain in my thumb get so bad that my shoulder surgeon (during a follow-up visit), grabbed my hand and took me to the "Hand floor" and introduced me to the surgeon there.

The following week I had what is called "Anchovy" surgery. It is specifically designed for bone on bone arthritic thumbs. It worked beautifully. I came home the same day and was playing mahjongg that week.

Unlike some of my other surgical experiences, my thumb is totally pain-free. I did wonder why my left thumb was bone on bone and yet my right thumb showed no evidence of arthritic involvement.

Here is the reason…..often our opposing thumb suffers the most because we use it more for steadying and supporting our daily activities. Hope you can have a similar experience. May you have joy today. Chris

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@artscaping

@hensy, Good afternoon. I noticed that you are considering "thumb" surgery. I let the pain in my thumb get so bad that my shoulder surgeon (during a follow-up visit), grabbed my hand and took me to the "Hand floor" and introduced me to the surgeon there.

The following week I had what is called "Anchovy" surgery. It is specifically designed for bone on bone arthritic thumbs. It worked beautifully. I came home the same day and was playing mahjongg that week.

Unlike some of my other surgical experiences, my thumb is totally pain-free. I did wonder why my left thumb was bone on bone and yet my right thumb showed no evidence of arthritic involvement.

Here is the reason…..often our opposing thumb suffers the most because we use it more for steadying and supporting our daily activities. Hope you can have a similar experience. May you have joy today. Chris

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@artscaping Glad your surgery worked out for you . I never heard of Anchovy surgery . How do they do that Chris. ?

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I have arthritis in my thumbs starting about 3 years ago. The doctor prescribed Diclofinac ointment. I apply it about 3 times per day. It helps take the edge off. I also do the recommended exercises.

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@karencar

I have arthritis in my thumbs starting about 3 years ago. The doctor prescribed Diclofinac ointment. I apply it about 3 times per day. It helps take the edge off. I also do the recommended exercises.

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@karencar My Dr. also told me to use thumb splints at night ,also the Diclofinac gel which is Voltaren . It was to expensive for me even with insurance so I just use Arnica cream which I like. Back in 2013 my Dr. injected hyaluronic acid in to my thumb I'm just now starting to have problems with it ocassionaly but not enough for a injection instead I found a supplement that has collegeen and H.A. in it . going to try it for myself

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