Pyrocarbon thumb joint replacement

Posted by var122 @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.

@geminipt

Hi Sue, my name is Jeanine. I saw that you had a tightrope procedure with good success. Can I ask what made you chose that over the "anchovy procedure?"

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Jeanine –
I consulted at length with my hand surgeon about my general health, stability (a big concern due to extensive bone loss), recovery time, and lifestyle questions (I do a lot of gardening, sewing, painting & childcare.) We decided the tightrope was the best option – increased stability, shorter recovery. I had the first one done 3 1/2 years ago, the second 8 months ago. Each time I was only totally immobilized for 2 weeks, in a hard splint for 6 more weeks, then as needed. I started hand therapy at 4 weeks and did exercises for a little over 4 months. Sue

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I have seen 2 hand surgeons and one is recommending the tightrope procedure. The hand surgeon at the Mayo Clinic is recommending to avoid that procedure and to have the LRTI with suspension. I have researched the LRTI and found that you lose strength and function and have shortening of the thumb. Those are not the types of outcomes that I want, so now I am leaning back toward the tightrope procedure even though the hand surgeon at the Mayo Clinic said it has a high failure rate. I am a physical therapist and my hands are my life. If you don't mind me asking, where did you have your surgery?

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@stoney

My implants were done by a non-Mayo hand surgeon from Marshfield WI (Steven Sanford). The implant is called Stablyx but I would recommend the Biopro implant because it is more of a ball and socket. With the Biopro, you're getting two brand new surfaces, free of arthritis and defects. The Stablyx only provides a new "ball". I am coming up on three years for both thumbs. They healed equally well. Strength is 90%. I have permanent, low-grade numbness in both index fingers. I'd do it again but with Biopro. I'm 62. The Mayo Clinic system is amazing and by far, my first choice for all major surgeries. I had prostate surgery about a year ago and Mayo treated me extremely well. They have nice hotel accommodations attached to the clinic so you never have to even go outside. Dr. Steven Moran M.D. is a good first option for a hand surgeon. I can help you more with the info if you need help.

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Hi, I am looking at the LRTI procedure by a hand surgeon at the Mayo Clinic in Jacksonville. Can you tell me, did Dr Steven Moran do the Stablyx on your thumb?

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@geminipt

I have seen 2 hand surgeons and one is recommending the tightrope procedure. The hand surgeon at the Mayo Clinic is recommending to avoid that procedure and to have the LRTI with suspension. I have researched the LRTI and found that you lose strength and function and have shortening of the thumb. Those are not the types of outcomes that I want, so now I am leaning back toward the tightrope procedure even though the hand surgeon at the Mayo Clinic said it has a high failure rate. I am a physical therapist and my hands are my life. If you don't mind me asking, where did you have your surgery?

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I had it at Twin Cities Orthopedics in Minnesota – I asked my hand therapist (almost 20 years of experience) about what she sees – she said she has seen one failure of the tightrope due to a fall, and one due to a construction worker returning to work too soon, out of 100 or more tightrope patients she has helped. She called it comparable to the anchovy failure rate.
Sue

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@stoney

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.

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i am getting ready to have my left thumb surgery. my surgeon put me in a soft brace for 6 weeks, not sure why. he would like me to retire first, not sure if i want to go that soon, he also doesn't do the implant surgery, says the other surgery with the tendon has been done for 50 years and it works. all that i have ready regarding the implants seem to be very positive and faster healling. not sure if delivering mail has impacted the problem since its the joint failing but it doesn't help. would you recommend the implant?

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Hello @usps123 and welcome to Mayo Clinic Connect. It sounds like your surgeon is leaning toward recommending the tendon surgery but you are interested in exploring the option for the implant.

Members such as @var122 @sueinmn @mapleskoff and @mihalcin have shared various procedures and/or interest in exploring options and may be able to offer you their thoughts.

Have you scheduled your surgery?

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@usps123

i am getting ready to have my left thumb surgery. my surgeon put me in a soft brace for 6 weeks, not sure why. he would like me to retire first, not sure if i want to go that soon, he also doesn't do the implant surgery, says the other surgery with the tendon has been done for 50 years and it works. all that i have ready regarding the implants seem to be very positive and faster healling. not sure if delivering mail has impacted the problem since its the joint failing but it doesn't help. would you recommend the implant?

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Hey USPS123, That brace thing was a waste of time. I would not recommend the "Anchovy" technique. If you're leaning towards a natural surgery, explore the "tightrope" technique. It sounds like you have a lazy surgeon who has not done much to advance medicine. Does he or she still practice "bloodletting"? I would recommend the Biopro modular implant. I wish I had selected it. I went with the Stablyx implant and I am satisfied but it took a long time to get there.

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