CMC Arthroplasty with STABLYX Implant

I was at the end of my tolerance with both hands, chose the tightrope with trapeziectomy for both, and have had zero issues. I wrangle 2 little grandsons, garden, quilt, paint... without issue. There is maybe a 10-20% loss of strength, but since I was at an 80% loss before surgery it is great. I am at 80% grasp strength after 8 months on the second. For those things that require strength, I learned to use the base of the thumb. My friend had her anchovy procedure 3 months before my tightrope, and was still trying to recover 1 year later. I was at 80% at 5 months, full recovery at about 7-8 months.
I found rigorous adherence to my therapy was key.
Sue

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Having it done in March, we shall see. I have worked in it for almost 20 years so I am well aware of the + and - of surgery and possible outcomes. Always got a dnr even for a wisdom tooth lol.

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I am 5 weeks post stabylx CMC thumb implant with significant sharp pain when I oppose my thumb to pinky. Considerable swelling on thumb muscles and tender swelling at the implant location. Am I expecting too much at 5 weeks?

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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.

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Yep! Remember, every nerve and muscle in that part of your hand has been assaulted. Most hand therapists are thrilled if you accomplish thumb to pinky at 5 weeks at all, pain or not. Ice is your friend - do any prescribed stretches or exercises, then ice at least 3 times a day for at least 20 minutes until the swelling is gone. With my left CMC last year, I iced at least once a day for over 2 months before all the swelling was gone, and they didn't replace the joint.

What are your current therapy/stretching protocols?
Sue

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No therapy, just return to everyday activities. I am an OTR, so I do ROM daily with my thumb and hand. I am now 12 weeks post surgery and besides all of my ADLs, I have some therapy “toys” to add resistance to my motion. I have full ROM, strength is good. I have soft tissue swelling in my thenar eminence and discomfort at the base of my metacarpal with “squishiness” with thumb rotation. I am hoping this goes away.

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@ras65 I too read the reviews about the tightrope potentially snapping. However, in my (mostly older) groups of gardeners and seamstresses, there have been many repaired CMC joints, and those who have the tightrope have been quite satisfied with it. I knew Stablyx wasn't for me after my own negative experiences with metal poisoning from chromium cobalt hip implants and complications suffered by two friends. I also knew the "tendon harvest" method carried a longer recovery time than I was willing to deal with. The hand surgeon who uses the tightrope was highly recommended by my ortho, whom I respect greatly.
I have dealt with the possible "fragility" of the repair by wearing a brace when I do heavy work (I do my own gardening and landscaping, including stonework, removing shrubs, etc.) This predated the surgery because I have also had a carpectomy, which affected the strength and stability of the wrist as well. So far, so good.
Good luck deciding on your next step, I hope there is a solution to the pain you are dealing with.
Sue

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I work in surgery and I am terrified I may have to retire. I am having a
stables implant done March 8 as from what I have read the recovery time
On the other options is just not reasonable. I work with skeletal
dynamics products regularly and trust the person who invented the
implant. Having it done by a doc I have worked with almost 20 years will
be the first time for both of us but I can have the other procedures
done if this doesn't work as you do not lose the bone. Fingers crossed!

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