Whether from bone fractures, congenital deformities, or degenerative diseases, severe hand conditions can be debilitating and prevent one from enjoying life to the fullest. No one knew this better than Sheryl, a recent patient of Check C. Kam, M.D., F.A.A.O.S.. The arthritic pain in her thumbs got so bad that she was unable to dress, cook, and clean.
After attempting to relieve her pain with conservative treatments over the course of four years, Sheryl turned to, Dr. Kam, a board certified orthopaedic surgeon specializing in hand and upper extremity treatment, at South Florida Orthopaedics and Sports Medicine, for help.
She and Dr. Kam decided that surgery would give her the best chance to lead a normal life again. After bilateral thumb surgery, a CMC arthroplasty to be exact, Sheryl’s life was literally transformed.
“I don’t have the pain anymore,” says Sheryl. “Dr. Kam prepared me for what to expect from the surgery, so I was realistic going into it. And it went so much better than I ever thought it would, and I healed so fast.”
What Is Thumb Arthritis?
The thumb joint, specifically at the carpometacarpal (CMC) junction, is a common victim of arthritis, particularly among women.
Arthritis is an inflammatory and degenerative disease that irritates and erodes a joint. Through natural wear and tear over many years (a condition called osteoarthritis), the delicate cartilage covering the bones can deteriorate, causing friction and damage to the bones in the thumb joint.
Thumb arthritis generally happens in people over forty-years-old. Having a previous fracture or injury can increase one’s chances of developing the disease.
Some common symptoms of thumb arthritis include:
- Significant pain when gripping or pinching, such as opening a jar, unlocking a door, or buttoning up a shirt
- Inflammation and sensitivity at the base of the thumb
- Aching after continued use
- Developing a bony protrusion over the joint
- Decreased range of motion
“I was diagnosed in Iowa five years ago with thumb joint arthritis,” says Sheryl. “Finally this winter, it got to the point where I was disabled in the kitchen. I couldn’t twist any jar lids off. It hurt to button my blouses, shirts, and pants. It hurt to do laundry and to put my dry shorts and pants on the skirt hangers. I even burnt myself with the iron this winter. I didn’t have the strength to hold an iron anymore.”
Non-Surgical Treatments for Thumb Arthritis
Following the early onset of thumb arthritis, conservative treatment methods may provide relief of symptoms. Common therapies include:
- Icing the joint for about ten minutes several times a day
- Taking an anti-inflammatory medicine such as aspirin or ibuprofen
- Wearing a splint to support the thumb, limit mobility, and allow the joint to rest
Due to the degenerative nature of the disease, a patient’s symptoms may get worse over time. Steroid injections into the base of the thumb may be used as the next line of defense in treatment. Typically, injections provide symptom relief for up to several months.
“I started seeing Dr. Kam four years ago when I first moved to Florida with my thumb joint pain,” says Sheryl. “We did shots for several years just to relieve the pain, and every time I came back to see him, Dr. Kam remembered my first name. He always talked and encouraged me about the surgery, and explained thoroughly how the procedure could provide a cure for thumb joint arthritis. He worked with me just beautifully.”
When Sheryl’s condition deteriorated to an unlivable and unmanageable level, she decided to take matters into her own hands and opt for surgery. “Finally, arthritis did worsen to the point where I called the office, and I said ‘I’m going to make an appointment with Dr. Kam. I want thumb joint surgery,’” says Sheryl.
How Is Thumb CMC Arthroplasty Performed?
Carpometacarpal (CMC) thumb arthroplasty can usually be performed on an outpatient basis. The procedure involves removing all or part of the damaged joint and reconstructing it using a tendon graft or artificial implants. Synthetic spacers may also be used to cushion the space between the bones.
Metal components are often suitable for older patients who have fewer functional needs as the implants are apt to break down under heavy use. Spacers are more frequently used with patients who are younger or have a more active lifestyle, as the failure rate is lower but with an increased risk of complication.
Results and Recovery After Thumb Surgery
Following surgery, the thumb is protected and stabilized with a splint or a brace for roughly three weeks. Afterward, the patient begins a rehabilitation protocol under the guidance of a certified physical therapist to regain full range of motion and improve muscle strength. Medical studies confirm that thumb arthroplasty improves clinical outcomes and maintains thumb joint stability in patients with arthritis.
Sheryl credits the support she received from everyone at South Florida Orthopaedics and Sports Medicine for her quick and safe return to regular, daily life functioning. “The whole staff is just great,” she says. “The occupational therapy that you have after the surgery is excellent. They make you work. You get to know them on a very personal level. They remember everything we did the week before. It’s really top-notch.”
Following the success of her bilateral thumb joint surgery, Sheryl recommends the procedure for anyone suffering as she did. “If your hands are hurting, it doesn’t have to hurt,” she says. “Have the surgery. I know I’m going to be with Dr. Kam again. I can already tell that I’m going to have some issues come up with my knuckles. I am ready. Whatever he recommends, as far as surgery, I’m in the game.”