Thumb arthritis: Did anyone have carpometacarpal (CMC) surgery?

Good evening @dmk, as a matter of fact, I have had that surgery on both thumbs. The left one was done 10 years ago and the right one was done early this year. I am more than just satisfied with the results. I am thrilled. ......Especially with the right one. That is my dominant hand and it is great to be able to open the salad dressing again.

I haven't heard the word knotted used before. However, my tendon removal scar is about 4 inches long. The thumb from the recent surgery is much more flexible than the older one. Perhaps that is because I had PT and did at-home exercises for a couple of months this time.

If there is any experience that surprised me it was the "hard brace" I had to wear for three months post-surgery recently. It both hindered my recovery and enhanced it. "Hindered" because I was unable to do things that I wanted to do like drive. "Enhanced" because it kept me from overusing the thumb which is on my dominant hand.

Is this the information you wanted? Anything else? Have you selected a surgeon?

May you be safe, free, and protected from inner and outer harm.
Chris

There are alternatives to loosing your FCR tendon (the LRTI procedure) - Tightrope uses biosynthetic string instead of your tendon, Bio Pro and Stablyx are implants that keep your trapezium in place, although cutting the FCR may be required. Each of these procedures offer different outcomes, and are designed to accommodate your needs. What do you want to be able to do after the surgery? With LRTI and Tightrope, you usually get great pain relief, keep your grip strength, but lose your pinch strength - so 4 of the surgeons in my area have explained to me. I had the Stablyx implant (had to go to San Fransisco because all of the surgeons here refused). I had my pinch strength back and stronger in 1 month, but the rest is taking longer. For me, doing the pt exercises post-op is critical, and after almost a year, I still take a moment to do mine, to keep up my strength. Pinch strength is important to me because of my woodworking hobbies - gripping odd-shaped pieces between thumb and forefinger.
Anyway, check out the blogs on these other procedures for other opinions. Hope they help you decide, and hope you get relief from your pain.
Good luck
GregV

@dmk, you may also be interested in this related discussion:
- CMC Arthroplasty with STABLYX Implant: https://connect.mayoclinic.org/discussion/cmc-arthroplasty-with-stablyx-implant/

@dmk I too have had CMC surgery - the first one over 10 years ago, the second in 2020. Both hand surgeons used the tightrope technique, which was important to me because I needed assurance of grip strength (I am a fiber artist and gardener, so use my hands extensively.) They have lasted wonderfully, the recovery was shorter by several months than my friends had with the "anchovy technique" using the FCR tendon. The pain, except during exercises, was negligible after about 2-3 weeks. Never did use any of the narco meds after the first night, relying on ice, elevation, alternating ibuprofen & tylenol instead.

I am part of a large gardening community, and this is a common operation for us - the most successful recovery was in people whose had an experienced hand surgeon, an excellent hand therapist (specially trained OT or PT), followed the recovery protocol, and continued daily therapy for at least 6 months. Also, ice, elevation & complete rest for at least 2-3 weeks to keep the swelling down, and wearing the hard splint until fully recovered were also key.

I chose not to try the Stablyx implant because the failure rate, according to my hand therapist, was higher in very small hands, which I have. I admit to being ultra-protective, wearing my thumb splints when doing heavy garden work like pull out bushes by the roots.

Sue

Thanks for the info. I see a military hand surgeon, Dr Hyatt. The first injection I had lasted almost 5 weeks pain free second one hasn’t worked very well. He has me in therapy to strengthen thumb preop. Osteoarthritis is mild to moderate but I have already had an RTS and TKR that I waited til severe not sure I want to wait that long to fix. It’s a long recovery period but shouldn’t be as long as my RTS but about same as my TKR was. Brace doesn’t stop pain either. My TKR is awesome! My RTS is very good but still have area he could not fix so I get dry needling every three weeks and tape it which has been good as I don’t want to live on anti-inflammatories for forever. Getting older is no fun! Thanks for your experience.

On Oct 5, 2022, at 11:04 PM, Mayo Clinic Connect wrote:



Oh dmk, do I ever agree with "not sure I want to wait that long to fix" - hands are different than a hip in one respect - when those tiny bones are too far gone for conservative surgeries, full joint fusion may be the only answer.

My best friend of 40 years was "too busy" when her wrists began to be badly damaged by arthritis, and waited until her schedule was better - too late! Now she has 2 fully fused wrists, and it is very difficult to do her everyday activities, and impossible to pursue some of her hobbies. She is now looking into a wrist implant because we have many years ahead of us. Another friend who had thumb joint problems did the same, waiting until he was retired - and ended up with 2 fused joints because everything had collapsed. Now he is trying to figure out how to modify his camera & fishing gear so he can continue the hobbies he retired to pursue.

So, as soon as the doc says "It's time" with a hand surgery, you truly are on the clock and delay may mean loss of use. Another caveat - these hand joints can be subject to a lot of wear after surgery, so get good advice on how to protect them from your surgeon and therapist. My hand and wrist, 11 years after a carpectomy, require a rigid splint whenever I am doing strenuous work like gardening or sanding painting. I wear a lesser splint for most other activities.

Have you thought about when you might proceed?
Sue

Omg thank you so much, that is extremely valuable advice of which helps me tremendously! Thank you thank you!



Hi, I had Trapizium surgery on my right thumb a month ago. I had severe swelling in all my fingers 2 days after. I still have swelling and stiff fingers. My PT says it’s from keeping my hand in a protective state. I did move fingers the best I could due to the swelling. Now I’m scared to death I won’t get the movement back in these fingers. I’m bending them to pain limits several times a day now. Holding them up icing. Etc. it’s also my dominant hand.

Is this normal? This pic was taken 2 days after surgery.

Oh yes, that's a pretty typical look two days after! I have had both thumbs done, successfully. The question is, have you started therapy with a qualified hand therapist? They can provide SO much valuable information and coaching to get you on the right track.
Sue

Yes, I’ve only had 3 visits so far. I’m going to PT that specializes in hand therapy. Is it normal for my whole hand to still be a little swollen and all my fingers pretty stiff? I work on the home exercises daily but the fingers just don’t want to bend and are all swollen at the joints.