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Do any of you know someone with arthritis of the basal joint of their thumb?

Posted by Kathy G on 4/12/05 at 17:02 (173072)

I'm looking for people who had the CMC joint replaced in their thumb. Here's a link to show you what I mean. Dont read it; just look at the bottom picture. I am talking about the joint all the way over to the left. http://www.sofc.com/news.html

I have been to two hand surgeons; both considered to be the best and brightest in the field. They both recommend surgery where they take a tendon out of the wrist, remove the CMC joint and graft the tendon to take its place. My problem is that it involves about ten weeks of limited use of the thumb, six months of physical therapy and about a year for complete recovery. Since I have OA in the right thumb as well, I would be favoring that hand and fear that at the end of the period, I would have to have to have the same procedure done on the right thumb. I also have bad OA in my left elbow and the other joints in the left thumb, as well as my left shoulder. I wonder if those areas would get worse from lack of normal use.

If I could find someone who's had the surgery done, it would help me immensely. I tried on the OA board I go to occasionally but the only message I got was from a woman who had just had it done and said she was in worse pain than ever. But she was just a week or so out from the surgery.

My rheumatologist, who tends to be very conservative, says I could have it fused or have a piece of silicone put in to take the place of the missing cartilage, thus cutting down on the rubbing of the two bones together.

I'm trying to decide if I should go the conservative route or the graft route. I'm got a call into the second surgeon who works out of the hospital with which I am most comfortable. When I saw him, we never discussed other options. Neither did the other surgeon and that's my fault but they were just gung ho on this relatively new procedure. I guess it's because I'm of my age. It's nice to know they think 55 is young!:) All I know is that today I shopped and drove my husband's car which is a bit bigger than mine and has a larger turn radius and my hand is killing me. I have to do something.

Do any of you have friends or relatives who have had any surgical procedure for OA in their hands? I know this is a foot board but this is a 'social' question.

Thanks and sorry for being such a bore.

Re: Do any of you know someone with arthritis of the basal joint of their thumb?

Ed Davis, DPM on 4/12/05 at 21:03 (173096)


I know a podiatrist with this problem. Casting patients for orthotics using several methods requires a lot of strain on that joint. He has not had surgery for the problem.

I have probably run into about a half dozen patients or so who have had the tendon transposition surgery and it was successful. If bone is rubbing on bone and use of the joint is very limited then the procedure seems to be a decent choice. I would probably see a hand specialist as you are doing.

Re: Do any of you know someone with arthritis of the basal joint of their thumb?

Kathy G on 4/13/05 at 13:06 (173133)

Thanks, Ed. I wear splints for it and I can use the hand. It just hurts! Both surgeons said it was a quality of life issue. I have a phone call in to the second surgeon today to see if he wants to see me to discuss other options or if he can discuss them over the phone. I think probably the former.

The first surgeon trained under one of the gurus of hand sugery in the US. He works out of Mass General. I liked him and if I have it done, I should probably go to him because he's been doing it longer. But as I said, it's in a different hospital from the one with which I am the most comfortable but they have an excellent reputation.