CMC Arthroplasty with STABLYX Implant

Ras65
I'm anxious to hear how you are doing.
I too have severe CMC arthritis in my left thumb. 60 y/o with high demand (surgeon,plays guitar and golf)
I've had 14 total steroid injections into the joint over 3 years and with time the injections have become much less effective to the point where I have pain all the time. I cannot take NSAIDS because of a kidney issue.
I have a similar path to the Stablyx having investigated the anchovy procedure and the BioPro implant.
I had a consultation with Dr Orbay and he recommended this procedure to me but it's only been around a short time and I could not find any reliable literature on it's long term success.
I don't think you should be having such a long post operative course with continued pain.
I hope you'll give me good news and tell me Dr. Orbay helped you and your doing better

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Hi Sue! I read your comments about the tightrope. I am also a Stablyx implant recipient (LT) in Dec 2017. I have not had a good experience. I'm active 56YO with young children, so I had to do what I could to could keep up in the future. Enter the Stablyx. I had another surgery in Dec 2018 to remove "scar tissue" which did nothing to relieve the pain. I have difficulty picking up my kids, who are now 6! If I simply bump the thumb, I'm on my knees, ready to pass out (I have passed out) from the pain. My hand surgeon moved his practice to Nebraska. I do have great insurance and had the therapies without fail.

I must do something. The next closest surgeon (80Miles) just happens to be Jorge Orbay, the inventor of the Stablyx implant, in collaboration with Skeletal Dynamics. I did see Dr. Orbay in April of 2019, for a second opinion. He told me by September, I'd wake up one day and realize my thumb is better. I was optimistic, but that optimism has vanished. I will see him again soon, to discuss surgical repair options.

Regarding the tightrope, I recently visited a new hand surgeon, regarding my RT thumb, with which I'm having a different pain, shooting up my arm. I thought it was a tendon issue, but I need the CMC repair on that thumb as well. He highly recommended the tightrope method. I read a patient testimony of the tightrope snapping and the resulting surgery. I have discounted the tightrope for that reason. I will wait until I have a positive outcome with my LT implant, before deciding what course to take with my RT thumb. I have seen the composite implants as well. If you have any experiences or know of others who can shed light on a good solution, I would greatly appreciate it!

Be careful with that tightrope! I'm very active and work with my hands, which are large for my size, so that's why the snapped case scares me!

Kind regards,
Alan

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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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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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Hello Shamu, after visiting with "The Duc" (hope this guy turns out to be my hero like "The Duke" John Wayne is - LOL ) and learning that he has performed over 100 of these Stablyx procedures without having to remove any of them - I'm sold. The other Doctor I was seeing has only performed 10 and had to remove 4. Surgery is on the 8th with Dr. Vo. I have a 2 hour drive to Dallas so my wife and I will stay in a Hotel close by the night before. Thanks for your feedback and keep me posted on your progress.

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Wallyworld,

I hope and pray all goes well. I think you will not regret the surgery. I guess I make up 2% of "the Dukes" successful surgerys. Follow his advise. DO NOT LIFT ANYTHING with your other fingers as I did with my surgery on my left hand. I was way over confident way to soon since my first one went so well. Keep me posted, don't hesitate to contact me.

SHAMU

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@wallyworld Like @shamu said, "Follow his advise. DO NOT LIFT ANYTHING with your other fingers as I did with my surgery on my left hand."

And I will add, "Ice! Ice! Ice!" If you have a 2 hour ride home, bring a pillow to support your arm & figure out a way to keep it iced. I have always been an advocate of icing injuries & surgical sites to minimize swelling, and my husband and daughter were a sports EMT & paramedic respectively. We ice everything - even cuts & bruises when painful.

After my recent tightrope surgery, I iced for the first 48 hours non-stop with a rotation of ice packs, then probably 12 hours a day for another week (every time I sat or laid down) and intermittently since, including after exercising it even now at 2+ months. I had almost NO swelling. On the other hand, 2 years ago, I followed the "20 minutes every 2 hours" plan and had swelling so bad the dressing sometimes felt like a tourniquet. If the surgery center give you gel ice packs, ask for the large (about 12"x16") one meant for back or knee - the cold from the wimpy little ones isn't enough to penetrate the surgical dressing.

One final note - when they transition you to a custom splint, and are preparing for the final "cut down" to just protect the thumb, ask if there is a real reason not to leave it 4-5" longer to support the wrist as well. I find it much more protective and more comfortable than any over-the-counter brace for heavy activities. My hand therapist of 20 years even "added back" to my right hand splint to use in the garden this fall, because to work without it is to invite pain and swelling, even 2 years after that repair.

Good luck, and be patient - healing takes time, even on a tiny little spot like a thumb.
Sue

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