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Hand Surgery - right hand Basal Joint - Arthritus

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Jul 16, 2019 - 1:57:27 AM
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n1wr

USA

785 posts since 12/27/2010

I play Bluegrass style. Visited with surgeon yesterday. Got a cortisone injection into joint, but he says I am a potential for joint surgery. He says surgery will eliminate the pain and improve thumb functionality, but will require extensive recovery and physical therapy.

Has anyone had this done? Your results and recommendations? Something I should do, or not. Well insured so cost not an issue.

Thanks for your time and thoughts.

Jul 16, 2019 - 3:44:36 AM

3152 posts since 7/12/2006

I had ut done on my right hand. Im left handed so its my chirdi f hand. It doesnt hurt but one thing i noticed is i bwluwve i have lost some grio strength because mt thumb seems to "cave in", or dip if you will where the thumb meets the hand (not at the wrist). But that may have come about because of my constantly gripping the guitar neck to make chords. When i bebd my thumb back it looks like im double jointed. I have adapted to it over time. I cant say how it may affect your thumb as far as doibg rolls. But if you do ad the doc says and keep up with thetapy u should be okay
.one thing about therapy though.dont be an over acheiver. Too much migjt noot be good. Obey the therapist and good luck

Jul 16, 2019 - 5:02:10 AM
Players Union Member

RioStat

USA

4896 posts since 10/12/2009

You alright there Gary ?

Jul 16, 2019 - 5:02:45 AM
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1277 posts since 10/5/2006

Hi Wayne
Sorry to hear that you are facing this difficulty. I am also in the same boat with my thumbs – both of them, and scheduled for surgery on the right hand in August.

You don’t say, but you will probably need Thumb basilar joint arthroplasty with LRTI. This is removal of the trapezium bone (carpometacarpal – CMC) with Ligament reconstruction and tendon interposition – LRTI).

Here is a video of the procedure:

https://www.youtube.com/watch?v=7R_6yUEZMFM

The recovery is lengthy, but generally successful.

I have just found information on a modified procedure that is less involved but promising that you may wish to check out. I have not thoroughly checked on this myself yet, but find it interesting.

http://noelhenley.com/2171/surgery-for-thumb-arthritis/

I am bone on bone in both hands and have been told the surgery is my only option as the condition will only get worse quickly. There have been implants surgically implanted to replace the trapezium, but the success rate is poor.

I have spoken with another person that has had the procedure (last August) and she is glad she had it done – successful outcome and now back to work. She is not a banjo picker – but her father is a well-known professional 5-string bluegrasser and she understands what the musicians hands must do. She has no doubt that there will be no problem returning to picking. Therapy is crucial and, as Gary Bates pointed out, important not to overdo it.

My surgeon says that banjo picking will be a major component of my postoperative therapy.

Best of luck to you!
Oldtwanger Frank Schoepf

Jul 16, 2019 - 5:13:25 AM

1277 posts since 10/5/2006

quote:
Originally posted by stanleytone

I had ut done on my right hand. Im left handed so its my chirdi f hand. It doesnt hurt but one thing i noticed is i bwluwve i have lost some grio strength because mt thumb seems to "cave in", or dip if you will where the thumb meets the hand (not at the wrist). But that may have come about because of my constantly gripping the guitar neck to make chords. When i bebd my thumb back it looks like im double jointed. I have adapted to it over time. I cant say how it may affect your thumb as far as doibg rolls. But if you do ad the doc says and keep up with thetapy u should be okay
.one thing about therapy though.dont be an over acheiver. Too much migjt noot be good. Obey the therapist and good luck


Gary, can you share with us exactly which procedure was done? 
I have been told that the ligament reconstruction and tendon interposition are supposed to stabilize that joint where the trapezium was removed to prevent the "cave in" that you describe.  I am concerned for my own prognosis and grip strength.

Jul 16, 2019 - 6:03:18 AM

3152 posts since 7/12/2006

The cave in seems to be at a joint above where the surgery took place. Sorta like 2 joi ts down from the tip of thumb. When i get home from work ill take some pics and send them to you. Just give me an email address in a private message

Jul 16, 2019 - 7:11:53 AM
Players Union Member

Helix1

USA

330 posts since 4/17/2019

I just got the two shots in my thumbs. I really need my hands. The next step is down the road. I haven't experienced any problems with tonnage. I already lost the first joint of my left thumb to cancer like 30 years ago.

We are all just too damn hard to kill


Jul 16, 2019 - 7:11:58 AM

Blackjaxe47

Canada

1441 posts since 6/20/2014

quote:
Originally posted by stanleytone

I had ut done on my right hand. Im left handed so its my chirdi f hand. It doesnt hurt but one thing i noticed is i bwluwve i have lost some grio strength because mt thumb seems to "cave in", or dip if you will where the thumb meets the hand (not at the wrist). But that may have come about because of my constantly gripping the guitar neck to make chords. When i bebd my thumb back it looks like im double jointed. I have adapted to it over time. I cant say how it may affect your thumb as far as doibg rolls. But if you do ad the doc says and keep up with thetapy u should be okay
.one thing about therapy though.dont be an over acheiver. Too much migjt noot be good. Obey the therapist and good luck


Are you alright, never seen so many typo's on one page......however I understand what your trying to say....interesting reply.

Jul 16, 2019 - 8:04:57 AM

mander

USA

3639 posts since 10/7/2007

Not exactly the same thing, but I had surgery on both my hands when I was in eighth grade. Trigger finger, bone spur, and repairing a severed nerve from an earlier injury. They fixed the trigger finger and removed the bone spur and thus far never had a problem with either. They improved the trouble I had with the nerve. I could use my thumb again. The numb sensation has never gone away, but hey! It's better than it was!

I hope the best for you! Surgeons these days can do miracles!

Jul 16, 2019 - 8:40:59 AM

3152 posts since 7/12/2006

 
 
 
 
Lol im okay. Just a terrible texter.big thumbs lol

Originally posted by Blackjaxe47
quote:
Originally posted by stanleytone

I had ut done on my right hand. Im left handed so its my chirdi f hand. It doesnt hurt but one thing i noticed is i bwluwve i have lost some grio strength because mt thumb seems to "cave in", or dip if you will where the thumb meets the hand (not at the wrist). But that may have come about because of my constantly gripping the guitar neck to make chords. When i bebd my thumb back it looks like im double jointed. I have adapted to it over time. I cant say how it may affect your thumb as far as doibg rolls. But if you do ad the doc says and keep up with thetapy u should be okay
.one thing about therapy though.dont be an over acheiver. Too much migjt noot be good. Obey the therapist and good luck


Are you alright, never seen so many typo's on one page......however I understand what your trying to say....interesting reply.


Jul 16, 2019 - 9:23:24 AM

176 posts since 6/25/2016

Can banjo playing actually cause this problem ? My dad just had the surgery and is recovering well. He's a guitar player but working very hard with his hands for 40+ years is obviously the cause of his problem.

Jul 16, 2019 - 10:28:07 AM
Players Union Member

Ryk

USA

208 posts since 11/20/2011

Same problem with both thumbs. I was examined and spoke with a hand specialist at Dartmouth Hitchcock in NH. I ended up doing nothing at the time. Further investigation pointed out a particular operation done at John Hopkins in Baltimore. I'd been living with it as it's come and gone until i met an acupuncturist who has been wonderfully helpful. There's still a problem but not being interested in a gamble over my hands unless it's absolutely necessary, living with it's been the answer with the acupuncturist's help.

Good luck with whatever road you choose,

Ryk

Jul 17, 2019 - 1:29:45 AM
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3152 posts since 7/12/2006

LOL Im alright. I had typed that on my phone which i always hit the wrong keys. i usually go back over it and correct, but i was at work  on break  and didnt have much time. Add to that i was a bit worn out from the heat yesterday at work. The shipyard is brutal in summertime. anoither year and a half and im outta there!
quote:

Originally posted by RioStat

You alright there Gary ?


Jul 18, 2019 - 1:53:29 PM

cjanak

USA

159 posts since 8/31/2004

I had removal of the trapezium bone (carpometacarpal – CMC) with Ligament reconstruction and tendon interposition in 2013. Here they call it a trapeziodectomy. I wasn't in constant pain, however the wrong pressure could bring me to my knees. The shots were worthless for me. I had good result after the surgery, with no more pain for nearly five years. Then I noticed that the thumb was caving down as mentioned before and the pain was returning - mostly a wicked ache. Since my Mom had the same thing - and I had seen how bad it can get, I opted to have the thumb, at that joint, fused last Sept. It required the fusion surgery, six weeks of recovery and then surgery to take out the pins used to fuse. I was told that a pretty small percent of people need this second surgery - in my case it's genetics. It's been six months now and the thumb is working very well. It is completely mobile - , and I can crochet again for the first time in years and no pain. One thing you should know - this procedure shortens your thumb reach by up to 1/2 inch. This was done on my right hand and I'm right handed so it made very little difference in my picking. I just had to figit with the pick a little. However - my left hand also could use the surgery - it's bone on bone already- and I'm very reluctant to have it done because I feel I won't be able to reach the chords as well. Because my predominant hand is OK now - I can baby the left and perhaps skip the other thumb being done. For now at least it's being quiet.
As mentioned before - follow up therapy is very important, so I urge anyone to maintain the PT schedule.
I went to six hand specialists before I picked one, because I was so concerned about being able to play - so I also suggest due diligence. I live in CT and would recommend him. Any other questions I would be happy to answer
Good luck,
Carol

Jul 23, 2019 - 3:46:08 AM

n1wr

USA

785 posts since 12/27/2010

I have read through all of the posts - thank you all for taking the time to respond - the greatness of this site.

After a week I can say the cortisone shot has helped a little, but I don't think it will be the final answer. I can't see going through that three to four times a year. I know I am heading for the surgery - thumb basilar joint arthroplasty with LRTI. This is removal of the trapezium bone (carpometacarpal – CMC) with Ligament reconstruction and tendon interposition – LRTI. From what I have seen on the internet their are a couple variants of that surgery, so I'll have to do my homework. Thanks especially to @cjanak and @Oldtwanger Carol and Frank for really good info.

I'll get back when/if I opt for the surgery.

Jul 24, 2019 - 7:26:58 AM

1277 posts since 10/5/2006

For those who may be interested - I've attached a pdf of my appointment at the Curtis Hand Center Musician's clinic.


Jul 24, 2019 - 7:47:09 AM

cjanak

USA

159 posts since 8/31/2004

Wow - It's really nice to see other options out there. Especially for my left thumb. Still hoping to avoid surgery but I know it's a distinct possibility.
thank you,
Carol

Aug 13, 2019 - 5:32:12 AM

n1wr

USA

785 posts since 12/27/2010

All - an update. It took a little while for the cortisone shot to take effect. All in all it has worked for me - the pain I was experiencing is mostly gone, and I have significant use in the right thumb back. Back to playing banjo - trying to re-capture what I've forgotten. Thanks for all the input and most definitely will keep notes for future reference. Good luck to all struggling with this issue.

Aug 13, 2019 - 11:44:10 AM

1277 posts since 10/5/2006

quote:
Originally posted by n1wr

All - an update. It took a little while for the cortisone shot to take effect. All in all it has worked for me - the pain I was experiencing is mostly gone, and I have significant use in the right thumb back. Back to playing banjo - trying to re-capture what I've forgotten. Thanks for all the input and most definitely will keep notes for future reference. Good luck to all struggling with this issue.


Congrats Wayne!  My first shots lasted close to a year; no longer work.
My LRTI surgery scheduled tomorrow has been postponed indefinitely because my systolic BP is spiking - evidently from the stress and needs to be brought under control.  That'll take my recovery into the bad weather.  Bummer.
Glad you're doing better.

Aug 14, 2019 - 8:30:09 AM

cjanak

USA

159 posts since 8/31/2004

For those who are either waiting for surgery or trying to postpone there are two things I can recommend for some relief. The first is BioFreeze by Performance Health. It's what the local PT's use here. The strongest form is on Amazon for some reason. It's no miracle but it does help. The second is a support that is made for the thumb - it's a foam strap. I put that on at night so I don't hurt it but curling it up under me. There are a couple different types and one does work better than the other.
As I mentioned before - I'm extremely reluctant to go back for my left thumb, and now I have other health issues that make the surgery just now inadvisable.
Good luck to you all,
Carol

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