CMC Arthroplasty with STABLYX Implant

Posted by joynett @joynett, Nov 14, 2018

Hello! 😃 Has anyone had this procedure? I had the LRTI procedure on my left thumb/wrist 10 years ago with great results. But this time, my surgeon suggested the STABLYX implant due to my age and lifestyle. My surgery is scheduled for 11/21/2018 and would love to hear of anyone's experience who has had this procedure done. Thanks!

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@lkd

Hi Wallyworld, The surgery went well, pain was well controlled before they sent me home. Only needed the pain meds the day of the surgery and into the next day. Tylenol and ibuprofen managed it well. However the recovery has been slow. I got out of the cast after 2 weeks and started physical therapy excercises the next day, which was a Thursday. On Friday my hand was swollen like a balloon and was throbbing so bad I was in tears and had to take the pain pills. Dr. Vo said I wasn’t ready to come out of the cast so it went back on for another 5 days. So I’ve only been out of it a week and am doing the exercises but I am still swollen and have throbbing pain by the end of the day. I do have Lupus and it has caused the inflammation issues so I am just having to push thru it, but I also use the pain medication. I did notice last night that the swelling has calmed down so I am hoping I have turned the corner and it will go uphill from here. It’s too soon for me to say weather it has worked or not. Right now I’m just working on the mobility part but Dr. Vo said in 2 weeks we will start on the strengthening. Because of my underlying conditions and COVID, I do the P/T at home and I like it better that way. Dr. Vo has been wonderful and helpful along the way. I am hopeful it is all worth it in the end.😀 If you do decide to go for it, I am sending you well wishes for a successful surgery. P.S. Warm heat on the hand seems to do much better for me than ice. So keep that in mind if icing hurts.

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Thanks lkd, I don't plan to have my surgery until mid-September as I'm recovering from prostate surgery due to enlargement. thank god it wasn't cancer. Please keep me posted on your progress. Unfortunately, both my thumbs are toast so I'll be getting them both done this year. I'm still trying to decide between Dr. Vo and another surgeon, that's why I'm interested in your feedback. I do believe in second opinions, experience and reviews like what we see here. Thanks for your advise and I hope you get to feeling better soon.

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@wallyworld

Thanks lkd, I don't plan to have my surgery until mid-September as I'm recovering from prostate surgery due to enlargement. thank god it wasn't cancer. Please keep me posted on your progress. Unfortunately, both my thumbs are toast so I'll be getting them both done this year. I'm still trying to decide between Dr. Vo and another surgeon, that's why I'm interested in your feedback. I do believe in second opinions, experience and reviews like what we see here. Thanks for your advise and I hope you get to feeling better soon.

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Whole heartedly agree about second opinions. I was seeing a different hand surgeon too. However, I wasn’t thrilled with his options on surgery or his bedside mannor. Researched other doctors and came upon Dr. Vo, whom ultimately I decided on going with.

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@shamu

Hey wallyworld,

I think the world of Dr. Vo . He seems to have an aggressive recovery plan compared to some. I think his advise to go to work and or be active is dead on. Read my posts that I just responded to. I'm sold. I think by the time I have 2 years behind on both thumbs I will not even think it ever happened. Best of luck.

SHAMU

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Hello Shamu - yep, keep me posted on your progress as well as you're further along with Stablyx implants. I'm an active early retiree and the implants look like the best option for quick recovery and regaining strength. Unfortunately, my first visit with Dr. Vo didn't impress me but I'll visit with him one more time before a make a decision.

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@wallyworld

Hello Shamu - yep, keep me posted on your progress as well as you're further along with Stablyx implants. I'm an active early retiree and the implants look like the best option for quick recovery and regaining strength. Unfortunately, my first visit with Dr. Vo didn't impress me but I'll visit with him one more time before a make a decision.

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Wallyworld,

I had several visits with Dr. Vo for hand injections. I have also seen one of his partners, Dr. Zoys for my stinking bad knees back as far as 2015. During my thumb issues Dr. Vo also saw me for my knees and injections and maintenance on them. My wife has also seen Dr. Vo in the last year for a knee issue.

Dr. Vo has an interesting history as far as how he became the joint doctor he is today. Short, very short story is he went to med school to be a neurosurgeon. During school in a pick up basket ball game he severely injured his ankle and foot. Totally impressed with his doctor that did his procedure and repairs he became fascinated with the ability to rebuild joints and do repairs. Now I believe the story goes that this doctor got dr. Vo involved under his wing in school and during this period Dr. Vo changed his major away from being a neurosurgeon after 2 years of study.

Some how I seem to be able to bring people out of there comfort zone and interact with them. I probably rub a lot of people the wrong way but through my sometimes cras honor and silly of the cuff joking and behavior many people loosen up and relax. In this way you get a better view of a person. Dr. Vo comes across maybe a tad dry. I have had him rolling on the floor. He has a great sense of humor.

One example, pre surgery with Dr. Vo he comes in and we talk about what is in store. He marked my right hand up and when he was done I told him that's great but I am in for my left thumb! The look on his face. PRICLESS, Lol.

Dr. Vo was the second surgeon I saw for my right thumb. The first Dr. was a female with years of experience. She gave me my first injection which was the worst experience I have ever had with any doctor. Pierced a major vein in my hand with the needle. Not injecting it, just poked right through it! Aside from the excruciating pain, when she removed the needle blood went everywhere. Her new trainee almost passed out. Lol.

After I regained my composier this doctor and I discussed surgery. The only surgery she preformed was the old school tendon roll up type which she told me I would be in a hard cast for 12 weeks and then therapy for 12-16 weeks. I still work. I am in shipping / receiving, inspection and part processes as well as part marking and identifying and assembly. This was not an option for me if I was to continue to work.

Get that second opinion. Oh and I explained my experiences with the previous doctor with Dr. Vo. He asked her name. I gave it to him and he exclaimed she had called him that same day to talk about the stablyx joint and procedure. Wow! I would not have let her do ANY work on me after my first visit! Lol.

SHAMU

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@shamu

Wallyworld,

I had several visits with Dr. Vo for hand injections. I have also seen one of his partners, Dr. Zoys for my stinking bad knees back as far as 2015. During my thumb issues Dr. Vo also saw me for my knees and injections and maintenance on them. My wife has also seen Dr. Vo in the last year for a knee issue.

Dr. Vo has an interesting history as far as how he became the joint doctor he is today. Short, very short story is he went to med school to be a neurosurgeon. During school in a pick up basket ball game he severely injured his ankle and foot. Totally impressed with his doctor that did his procedure and repairs he became fascinated with the ability to rebuild joints and do repairs. Now I believe the story goes that this doctor got dr. Vo involved under his wing in school and during this period Dr. Vo changed his major away from being a neurosurgeon after 2 years of study.

Some how I seem to be able to bring people out of there comfort zone and interact with them. I probably rub a lot of people the wrong way but through my sometimes cras honor and silly of the cuff joking and behavior many people loosen up and relax. In this way you get a better view of a person. Dr. Vo comes across maybe a tad dry. I have had him rolling on the floor. He has a great sense of humor.

One example, pre surgery with Dr. Vo he comes in and we talk about what is in store. He marked my right hand up and when he was done I told him that's great but I am in for my left thumb! The look on his face. PRICLESS, Lol.

Dr. Vo was the second surgeon I saw for my right thumb. The first Dr. was a female with years of experience. She gave me my first injection which was the worst experience I have ever had with any doctor. Pierced a major vein in my hand with the needle. Not injecting it, just poked right through it! Aside from the excruciating pain, when she removed the needle blood went everywhere. Her new trainee almost passed out. Lol.

After I regained my composier this doctor and I discussed surgery. The only surgery she preformed was the old school tendon roll up type which she told me I would be in a hard cast for 12 weeks and then therapy for 12-16 weeks. I still work. I am in shipping / receiving, inspection and part processes as well as part marking and identifying and assembly. This was not an option for me if I was to continue to work.

Get that second opinion. Oh and I explained my experiences with the previous doctor with Dr. Vo. He asked her name. I gave it to him and he exclaimed she had called him that same day to talk about the stablyx joint and procedure. Wow! I would not have let her do ANY work on me after my first visit! Lol.

SHAMU

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Hi Shamu, How long did your hand stay swollen and sore once you got out of the cast? I’m still swollen and my wrist is super sore. I’m just trying to gauge my recovery to someone else that had the Stablyx. Thanks...Lori

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Hey Idk,

I will tell you that we all will have our own recovery time depending on who we are and how we are physically. I am now 61, over weight, diabetic and physically not as active as I should be. That being said, I do still work and use my hands every day from small tedious tasks to grabbing the pallet shrink wrap roll on a handle and loading and warping skids. After 14 months my right is doing pretty good but I still get the GOTCHA moments when I push it.

As far as it went for the first surgery, The pain level was a steady 5-8 that first day, constant pressure with very little Sevier pain. I took a few pain pills over the next few days, maybe 4 total. I kept it iced down and did what I was instructed to do. 10 days later I went in for the follow up where the ace bandage and filler lining that kept my thumb immobile was removed. Other than the bruising and the hidden stitches all was good.

I went and did 6 therapy sessions over the next 3 weeks. ( I would NOT recommend letting them use ULTRASONIC on you. It caused me severe pain and can burn tissue when it bounces off the titanium implant, causes heat ) The therapy consisted of mainly 5 or 6 exercises. It is important to do the home work. Move the hand and thumb as much as you can. I did my exercises as often as I could. If I had a 10 minute break at work I would do 10 or 15 reps of each. For me, the one that seemed to give me, now this is me, the most flex ability without much pain is a foam fake basket ball made of soft foam that is the size of a tennis ball or slightly smaller. I would pick it up and squeeze it with all fingers clinching my fist around it, slow and mathoticaly squeezing. 10-50 reps. I then would squeeze it with just my thumb, in and out slowly. 10 to 50 reps. On my last drive from work to rehab which was 5 weeks after surgey I squeezed the ball 300-400 times while driving. The rehab people were amazed at my ability to function. After just 5 weeks out of surgery I was out of rehab. I could do all of their tasks well.

Now I have a hot tub which I would spend a half hour in at a time doing the hand stretches In front of the blasting jets. After editing the hot tub, I would then get the zip lock bag of ice and wrap my hand in a small towel with the ice pack on the back side of my thumb and wrapping around to my palm. I wold do this for 30 minutes or till all the cold drips landing in my lap would piss me off. Lol.

The exercises I would do are the touch the thumb with the tip of each finger, pressing for 3-5 seconds each and moving to next finger. I would do the rolling the wrist with fingers extended with my thumb against the index finger knuckle. I would then rotate it around and around like a Vanna White wave. Lol. Do it 10-15 times each direction. Slow mathotical circles.

Then the same hand position but just waving finger tips to fore arm downward and back straight up and back as far as possible. Then same hand position and rock the hand that is straight in line with arm and go side to side from left to right.

Then the one I do constantly to this day if I think about it or if I seem to get stiff is thumb to base of pinky finger then stretch it out as far as you can like a traffic cop STOP hand gesture. Hold it at both the pinky position and press and then stretch it out and hold. 5 seconds at each end of the motion.

At 14 months I still wake up with a stiff hand depending on if I sleep like a contortionist or curled up baby. As I make the trip to start my morning coffee I just run through the basic stretches and I'm good.

So give it a few weeks. Do the stretches. Find that fake basket ball and do the stretches. Ice after. Warm rag wrap before helps if your stiff. If you work, take it easy and dont push lifting.

I had planned to get both hands done in the same calendar year to try and utilize my insurance coverage. After having the right hand done in May and having 6 months pass I decided to proceed with left hand surgey in November. My right hand was no where near healed up but was doing well enough to give me confidence to proceed on the left thumb.

There will be days that your hand will be in discomfort. It's man made not original Equipment now. Weather changes will cause you aches. It's just part of it. Give it the 6 weeks it needs. Heat exercise and ice. Do the stretchs as often as your comfortable doing them. Work on strength down the road but keep it as flexible as you can. This will help keep the pain down. Best of luck...

SHAMU

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@lioness

@joynett I would be interested in hearing about these procedures also I have bone on bone in both thumbs right now I twisted it or something its hurting really bad today. I will put my thumb brace on.

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@lioness Have you had your thumb evaluated?

I had the bone on bone arthritis and I also think before I had the arthroplasty tightrope surgery that I also had trigger thumb and not it being a result of the arthroplasty, but did not notice the catching before surgery. So I had two different surgeries.

Do you think you might have trigger thumb along with arthritis?

I think actually the trigger thumb was giving me the most pain. With trigger fingers I have it has just been catching feeling.. and not being able to open the fingers.. but not pain. After the trigger thumb surgery the pain went down tremendously.

I honestly think I should have gone to a different surgeon. I now have some trouble with the tendon that runs from thumb to wrist and beyond. My surgeon seems to think that will go away in time.. meanwhile she said in a sarcastic tone “do you think you could put some arthritic cream like Ben Gay on it”. I told her I was already doing that and using heat because it seems to respond better to heat than ice.

I keep getting emails wanting me to review her, the surgeon.. on facebook. I'm not sure what to say yet.

Zee Gee

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@lkd

Hi Shamu, The surgery went well, pain was well controlled before they sent me home. Only needed the pain meds the day of the surgery and into the next day. Tylenol and ibuprofen managed it well. However the recovery has been slow. I got out of the cast after 2 weeks and started physical therapy excercises the next day, which was a Thursday. On Friday my hand was swollen like a balloon and was throbbing so bad I was in tears and had to take the pain pills. Dr. Vo said I wasn’t ready to come out of the cast so it went back on for another 5 days. So I’ve only been out of it a week and am doing the exercises but I am still swollen and have throbbing pain by the end of the day. I do have Lupus and it has caused the inflammation issues so I am just having to push thru it, but I also use the pain medication. I did notice last night that the swelling has calmed down so I am hoping I have turned the corner and it will go uphill from here. It’s too soon for me to say weather it has worked or not. Right now I’m just working on the mobility part but Dr. Vo said in 2 weeks we will start on the strengthening. Because of my underlying conditions and COVID, I do the P/T at home and I like it better that way. Dr. Vo has been wonderful and helpful along the way. I am hopeful it is all worth it in the end.😀

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@lkd Hi - I did not have the Stablyx surgery because 2 years ago the tightrope on the other hand gave me tremendous results, so I went with the same. I am about 8 weeks out from surgery, and the pain was largely gone by the second day. However, after 11 ortho surgeries for arthritis damage, I am an ice fanatic, so was icing at least 12 hours a day the first 4-5 days, then 4 times a day for 3 weeks. The cast came off at 2 weeks, replaced by a hard splint which has been cut down now and is only worn for heavy activities like wrangling toddlers and gardening.
As to PT, I think my recovery from the first surgery was helped by consistent 3X/day PT for months, and at least once a day stretching for over a year. I began stretching & flexing the moment the full cast came off, and pretty much had full motion at 6 weeks. I have begun the same strengthening regimen (with my trusted OT/Hand therapist) on the left as I used on the right, and have no doubt I will be as satisfied. I still use ice after any somewhat strenuous use (like bike riding yesterday) or when it aches.
If I had the surgery when I was younger (I am long retired) I would probably have opted for the Stablyx because of it's prediction for long term strength.
So to anyone considering any CMC surgery, I urge consistent icing and longterm 2X or more daily exercises.
Sue

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@sueinmn

@lkd Hi - I did not have the Stablyx surgery because 2 years ago the tightrope on the other hand gave me tremendous results, so I went with the same. I am about 8 weeks out from surgery, and the pain was largely gone by the second day. However, after 11 ortho surgeries for arthritis damage, I am an ice fanatic, so was icing at least 12 hours a day the first 4-5 days, then 4 times a day for 3 weeks. The cast came off at 2 weeks, replaced by a hard splint which has been cut down now and is only worn for heavy activities like wrangling toddlers and gardening.
As to PT, I think my recovery from the first surgery was helped by consistent 3X/day PT for months, and at least once a day stretching for over a year. I began stretching & flexing the moment the full cast came off, and pretty much had full motion at 6 weeks. I have begun the same strengthening regimen (with my trusted OT/Hand therapist) on the left as I used on the right, and have no doubt I will be as satisfied. I still use ice after any somewhat strenuous use (like bike riding yesterday) or when it aches.
If I had the surgery when I was younger (I am long retired) I would probably have opted for the Stablyx because of it's prediction for long term strength.
So to anyone considering any CMC surgery, I urge consistent icing and longterm 2X or more daily exercises.
Sue

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Hey Sue,

You sound like your good to go with all your efforts. Sounds like you had excellent insurance or assistance to be able to do all the OT/Hand therapy. Unfortunately for myself and I am sure many others, the fee's for surgery and therapy can be outrageous!

I had to pull money from my 401 K for my first surgery in May due to the high out of pocket expenses. The therapy after the first surgery still cost me $80 each visit. My decision to go for the surgery for the other hand before being completely sure of the first surgery was due mainly to the cost and the fact I was up to my annual out of pocket expense, 8-10 K.

Being late November, this limited me on how many therapy sessions I had left in the calendar year that were paid for by my insurance. When the tendon snap happened that set me back on the covered therapy since year end came. The last few therapy sessions came completely out of my pocket at $250 per. Needless to say I bailed out. I had to! I was confident with all the past experience with the first surgery and therapists that I could manage. So far so good.

If you have the funds and good therapists I say go for it. If you are like myself with limited income and insurance coverage, get the therapy you can afford but by all means keep at the therapy even if its on your own. Its a must for healing and longevity of the surgery.

SHAMU

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@shamu

Hey Sue,

You sound like your good to go with all your efforts. Sounds like you had excellent insurance or assistance to be able to do all the OT/Hand therapy. Unfortunately for myself and I am sure many others, the fee's for surgery and therapy can be outrageous!

I had to pull money from my 401 K for my first surgery in May due to the high out of pocket expenses. The therapy after the first surgery still cost me $80 each visit. My decision to go for the surgery for the other hand before being completely sure of the first surgery was due mainly to the cost and the fact I was up to my annual out of pocket expense, 8-10 K.

Being late November, this limited me on how many therapy sessions I had left in the calendar year that were paid for by my insurance. When the tendon snap happened that set me back on the covered therapy since year end came. The last few therapy sessions came completely out of my pocket at $250 per. Needless to say I bailed out. I had to! I was confident with all the past experience with the first surgery and therapists that I could manage. So far so good.

If you have the funds and good therapists I say go for it. If you are like myself with limited income and insurance coverage, get the therapy you can afford but by all means keep at the therapy even if its on your own. Its a must for healing and longevity of the surgery.

SHAMU

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@shamu Yes, insurance is the elephant in the room for many of us. I am totally blessed to have excellent coverage, and I know not everyone has the same opportunity. I do have a suggestion that worked for my sister. Sometimes, if you have run out of therapy coverage for the year, someone with whom you are an established patient will agree to see you for one or two sessions for just your copay amount if you explain the situation.

But, since rehab is mainly up to the patient, not the therapist, it is possible to fully recover by being as diligent as you are. For those who are unable to gain access to any in-person therapy, there are also excellent resources on-line. I would just caution people to look for videos or directions made and distributed by a reputable source - an ortho practice, a health practice like Mayo or a registered physical or occupational therapist. Avoid sources like random "trainers" or anyone trying to sell you a device.

Kudos for your self-discipline and hard work.
Sue

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