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var122
@var122

Posts: 14
Joined: Jan 15, 2018

Pyrocarbon thumb joint replacement

Posted by @var122, Jan 15, 2018

I do not know anyone who has had a cmc thumb joint replacement….anyone have any insight? I am 5 days post op.

REPLY

Hello @var122,

Welcome to Connect. Thank you for starting a discussion on thumb joint replacement. I have not come across someone who has had a joint replacement in his or her hand. We have many members discussing disc, knee, hip, and ankle replacements. I am very intrigued by your post.

@var122, if you don't mind sharing, how are you doing post replacement? Did you have the replacement due to an injury or arthritis? What sort of rehab have you been prescribed to do and what is your expected outcome as far as usage? I know I just rattled off a lot of questions, but as someone who went through a total knee replacement, I am always interested in learning about other joints and how others handle the recovery.

@JustinMcClanahan

Hello @var122,

Welcome to Connect. Thank you for starting a discussion on thumb joint replacement. I have not come across someone who has had a joint replacement in his or her hand. We have many members discussing disc, knee, hip, and ankle replacements. I am very intrigued by your post.

@var122, if you don't mind sharing, how are you doing post replacement? Did you have the replacement due to an injury or arthritis? What sort of rehab have you been prescribed to do and what is your expected outcome as far as usage? I know I just rattled off a lot of questions, but as someone who went through a total knee replacement, I am always interested in learning about other joints and how others handle the recovery.

Jump to this post

Hello!
I’m 1 week out of surgery & currently in the cast room. I had a splint for 1 week to accommodate swelling.
Attached are my post on photos.
I’m 45 yrs old, work as a Surgical First Assistant- Mayo Eau Claire.
To answer your questions
1) replacement due to arthritis. I had symptoms starting at age. I thought it was from doing too much yard work lol! But it never got better, just worse. I waited about 2 yrs before seeking help…
2) after surgery, I was in a split, now getting casted. I will be in a cast for 6 to 8 weeks.
3) according to my doctor, I will have full use & be 100% pain free & no braces to wear 🙂
I’ll have to keep you posted on the therapy after the cast comes Off
-Veronica

IMG_20180118_080101598

@JustinMcClanahan

Hello @var122,

Welcome to Connect. Thank you for starting a discussion on thumb joint replacement. I have not come across someone who has had a joint replacement in his or her hand. We have many members discussing disc, knee, hip, and ankle replacements. I am very intrigued by your post.

@var122, if you don't mind sharing, how are you doing post replacement? Did you have the replacement due to an injury or arthritis? What sort of rehab have you been prescribed to do and what is your expected outcome as far as usage? I know I just rattled off a lot of questions, but as someone who went through a total knee replacement, I am always interested in learning about other joints and how others handle the recovery.

Jump to this post

Thank you for sharing more Veronica,

For being one week post op, I had a hard time telling which one was done at first, the hand looks great. If you don’t mind me asking, how is the pain associated with this surgery? I think other members in the future will be interested to see your post, picture, and learn about how this treatment helped with arthritis in a hand joint.

@JustinMcClanahan

Hello @var122,

Welcome to Connect. Thank you for starting a discussion on thumb joint replacement. I have not come across someone who has had a joint replacement in his or her hand. We have many members discussing disc, knee, hip, and ankle replacements. I am very intrigued by your post.

@var122, if you don't mind sharing, how are you doing post replacement? Did you have the replacement due to an injury or arthritis? What sort of rehab have you been prescribed to do and what is your expected outcome as far as usage? I know I just rattled off a lot of questions, but as someone who went through a total knee replacement, I am always interested in learning about other joints and how others handle the recovery.

Jump to this post

I had a regional block with sedation for the procedure & an ON-Q Pain Pump placed at the time of the block. I was very comfy for the procedure. I was told the block should last about 20 hrs & the pain pump would help with pain management for 2 days post op. Unfortunately, my block started wearing off 3 hrs after the procedure & the pain pump didn’t help. So, when I noticed the block first starting to wear off (around 12:30pm), I took Tylenol & my Rx pain reliever, I’m sure it helped somewhat, but ended up have to take more Rx pain about 1 hour thereafter.
I was in a lot of pain the first day & was surprised on how much pain I did have being that the pain pump was there & I maxed out on Tylenol & Rx pain reliever! Thankfully, the first 48 hrs were the worst!! By day 3, I was fairly comfortable with minimal Rx pain reliever. By Post op day 5, I wasn’t even taking Tylenol.
I’m 1 week out today & virtually pain free. I have some discomfort after the cast was placed, but not enough to take anything at all.
My biggest recommendation would be to elevate & ice as much as possible for the first few days, and stay ahead of the pain with the prescribed medications.
I though I was going to be “good” as I started pain meds when I first felt the initial block wearing off. I did call my care provider in regards to my pain several hours after my surgery & she said that what I was feeling is “bone pain” & sounded fairly normal.

I have had the procedure done at a non-Mayo clinic by a specialized hand surgeon. I am over ten weeks post-op. I was bone on bone. The implant was a Stablyx by skeletal dynamics. I still have a lot of stiffness and swelling. Pain is still worse than pre-op. I’m hoping to turn the corner on this where I can say it was worth it. My therapist has never seen one of these prosthetics before so it’s hard to get answers about when I can expect positive results. I need a similar surgery on my dominant thumb and was hoping to have this at the Mayo Clinic in Rochester. I wanted to research the implant manufacturer but can’t find the name of the implant Mayo uses.

Hello!
@stoney – I’ll try to help with insight to my own experience.
First off, I too was bone-on-bone. I am 3 weeks post-op this past Wednesday. I will get my cast removed tomorrow, x-ray series & possibly another cast or splint.
Here is a link for what I have implanted: http://www.integralife.eu/products/recon/orthopedics/upper/hand-wrist/hand/nugrip-cmc-implant/
My size is 30s.
Right now, I can’t say whether I have improvement or not; too soon to say, lol! I will keep you posted on my own journey….
If you don’t mind a few questions:
1) how old are you?
2) what is your profession?
What does your surgeon say regarding your progress? Did he give you an idea of how you should be progressing?
My surgeon said it will take approximately 1 year from the surgery to have the optimal results….

Here is a patient brochure link: https://www.integralife.com/file/general/1453799948.pdf

@var122

Hello!
@stoney – I’ll try to help with insight to my own experience.
First off, I too was bone-on-bone. I am 3 weeks post-op this past Wednesday. I will get my cast removed tomorrow, x-ray series & possibly another cast or splint.
Here is a link for what I have implanted: http://www.integralife.eu/products/recon/orthopedics/upper/hand-wrist/hand/nugrip-cmc-implant/
My size is 30s.
Right now, I can’t say whether I have improvement or not; too soon to say, lol! I will keep you posted on my own journey….
If you don’t mind a few questions:
1) how old are you?
2) what is your profession?
What does your surgeon say regarding your progress? Did he give you an idea of how you should be progressing?
My surgeon said it will take approximately 1 year from the surgery to have the optimal results….

Jump to this post

Thank you for your info and link. I am 59 years old, USPS retired, but very active handyman. I had a mini CMC joint stabilizing custom splint brace applied to my surgical hand after only five days (cast removed)and the follow-up x-rays at two weeks. My surgeon did not schedule a follow-up exam. I live 150 miles from the surgery center. I am now waiting to hear from that surgery scheduling department about having identical surgery on the opposite thumb, so I guess the surgeon will get a chance to examine his work after all during my pre-op examination. I too have heard optimal results can be expected after one year. It will be 12 weeks post-op tomorrow and I was not expecting to have continued swelling around the surgical area and first finger. I have full use of the hand with obvious weight limitations.

I'll have my second cast (applied Feb. 9th) removed on March 5th. So, about 6.5 weeks total in a cast. I should be moving onto rehab after March 5th 🙂 I'm a bit nervous about it….

I had surgery on my thumb/wrist joint on January 8. So, I’m out 6 weeks. I still feel like I have a sprained wrist sometimes. Only take Tylenol once per day. I had a sling made from a tendon and another string attached to stabalize the Thumb so not a replacement. They said I was bone on bone and arthritic. I have been an artist and will continue hopefully.

@maplegrove

I had surgery on my thumb/wrist joint on January 8. So, I’m out 6 weeks. I still feel like I have a sprained wrist sometimes. Only take Tylenol once per day. I had a sling made from a tendon and another string attached to stabalize the Thumb so not a replacement. They said I was bone on bone and arthritic. I have been an artist and will continue hopefully.

Jump to this post

Hello!
That was one of the 3 options I was given also.
I didn't like the drawbacks of that surgery after reviewing my options.
My goals for my surgery were:
1) complete range of motion
2) keep dexterity
3) keep arm strength
4) have a fully functional joint as close to my original prior to all the arthritis.
Since I haven't been able to move my thumb, I don't really have any pain, so that's good…that may be another story after March 5 lol!
Mine was bone on bone too 🙁
Are you starting any therapy yet?

@maplegrove

I had surgery on my thumb/wrist joint on January 8. So, I’m out 6 weeks. I still feel like I have a sprained wrist sometimes. Only take Tylenol once per day. I had a sling made from a tendon and another string attached to stabalize the Thumb so not a replacement. They said I was bone on bone and arthritic. I have been an artist and will continue hopefully.

Jump to this post

Hi, I'm intrigued by your post. You said you had bone on bone osteoarthritis and they used tendons to stabilize the thumb? My left thumb does this thing where is i am doing just normal stuff like housework or whatever, it feels like it tries to dislocates and causes a 10 of 10 have to stop, hold it and say ouch pain. Then it is sore for days. They gave me a splint to wear to immobilize the thumb that helps a bit but i cannot work with it on. I was told that my surgeon would not do a replacement, but would use some kind of peg? insert? can't remember just know it was not a replacement. He said i had severe osteoarthritis and could see that my wrist area is deformed. If i take off my watch, which i hardly ever do, it does look a little strange. Basically i just avoid using the thumb. They prescribed OT but it is hard to find that in network in my location. Maybe once i finish PT for my 2nd TKA (18 days ago), i will have the time to check into it.

May i ask where you went to have the procedure done and what it is called? Were other options offered?

Hope you are all healed and functional soon.

Blessings

Hello Nancy, it sounds like you have instability in your CMC joint. I live in northern Wisconsin and had my procedure performed at the Marshfield Clinic. It is called a pyrolytic carbon implant of the CMC joint. It does look like a peg. There are numerous videos on Youtube for this procedure. The Mayo Clinic offers this procedure but my clinic was more convenient for me and I knew my surgeon already.
Well, I just had thumb #2 done 3 days ago. I have a pain pump and am in zero pain at least for one more day when the pump gets removed by my wife. O.T. is not going to solve your instability if you have biomechanical issues with cartilage and bone deficits. Xrays confirmed my specific problem and based on surrounding bone structures, I was a good candidate for this procedure. I am an active 59-year-old male who refused to settle for the barbaric LRTI method or fusion of the joint, although, those two options have been around forever.
My thumb was NOT in need of stabilization and NO tendons were used. I was offered a fusion of the joint or LRTI arthroplasty by the local orthopedists. I refused both of those options. The words joint replacement are probably misused. An implant is more appropriate and to the point. I would point out that the fusion option would stabilize the joint from dislocation, but the range of motion would be diminished(but it is probably already diminished from protective use).
Sacrifice is the key word here. I had to travel 150 miles one way to have this procedure performed by a specialist I personally researched and tracked down. There is limited specialization in northern Wisconsin so I had to travel. Getting a motel before and or after is almost a requirement. I, of course, needed a driver/caregiver for after surgery.

Best wishes moving forward.

@stoney

Hello Nancy, it sounds like you have instability in your CMC joint. I live in northern Wisconsin and had my procedure performed at the Marshfield Clinic. It is called a pyrolytic carbon implant of the CMC joint. It does look like a peg. There are numerous videos on Youtube for this procedure. The Mayo Clinic offers this procedure but my clinic was more convenient for me and I knew my surgeon already.
Well, I just had thumb #2 done 3 days ago. I have a pain pump and am in zero pain at least for one more day when the pump gets removed by my wife. O.T. is not going to solve your instability if you have biomechanical issues with cartilage and bone deficits. Xrays confirmed my specific problem and based on surrounding bone structures, I was a good candidate for this procedure. I am an active 59-year-old male who refused to settle for the barbaric LRTI method or fusion of the joint, although, those two options have been around forever.
My thumb was NOT in need of stabilization and NO tendons were used. I was offered a fusion of the joint or LRTI arthroplasty by the local orthopedists. I refused both of those options. The words joint replacement are probably misused. An implant is more appropriate and to the point. I would point out that the fusion option would stabilize the joint from dislocation, but the range of motion would be diminished(but it is probably already diminished from protective use).
Sacrifice is the key word here. I had to travel 150 miles one way to have this procedure performed by a specialist I personally researched and tracked down. There is limited specialization in northern Wisconsin so I had to travel. Getting a motel before and or after is almost a requirement. I, of course, needed a driver/caregiver for after surgery.

Best wishes moving forward.

Jump to this post

Hi Stoney,
Thanks for sharing.

So when my thumb feels like it is trying to dislocate, it probably is. I could not find the original x-ray back in the day when i just had osteoarthritis in the thumb joint. I found this from 2016

FINDINGS: No acute fracture or subluxation. Severe first
carpometacarpal degenerative joint disease with joint space loss,
osteophytes, and subchondral cysts. Mild first metacarpophalangeal
and interphalangeal degenerative joint disease. Mild triscaphe
degenerative joint disease.

IMPRESSION: Degenerative joint disease is most advanced at first
carpometacarpal joint.

All i know is when it is moved some certain way it feels like it is trying to dislocate (like my shoulder used to dislocate) and then is painful for days.

The surgeon who just did my two TKAs said something about that "plug" procedure. I don't know though, if yours was fixed by a specialist, then i probably should get a second opinion and referral before they go cutting on my thumb. Mayo would be my first choice. It is hard for me to get anything done; finding drivers/caregivers is more of a challenge than the surgery.

Thanks for the info. It helped.

Hope you stay pain free and have good results on #2 once the pain pump is removed.

Blessings,

n

@nancylh
Mine was a joint replacement. The formal name is a "hemi-arthroplasty".
I started this thread. The type of implant along with other information is in this thread with links to click for education 🙂
I had my joint replacement at Mayo Clinic in Rochester by Dr. Elhassen.
I put my 1st post-op xrays up here for you to see. Basically, they cut the end of my thumb bone off (cmc joint), made a hole into the center of the bone for the stem to be inserted into the thumb. Then, for the articulating surface, they burred a conical area for the "ball" part of the new joint to ride in….

xray

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