Perhaps you’ve just been told you need to have
thumb joint replacement surgery, but have no idea what that is, let alone if there are any risks, or what
the recovery time looks like.
We sat down with
Dr. Ying Chi, an orthopedic hand surgeon at Hoag Orthopedic Institute, to discuss all
things thumb joint replacement surgery.
Q: When is thumb joint replacement used?
A: The thumb LRTI joint reconstruction is done in patient with basal joint
arthritis of the thumb and debilitating pain which effects the patient's
hand function. It is an excellent pain-relieving surgery that does not
require fusion of the thumb joint, therefore preserves the thumb motion.
Q: Who’s the ideal candidate?
A: An ideal candidate would be someone with painful arthritis at the thumb
basal joint but wants to preserve thumb motion and decrease pain. We do
not recommend young patients (younger than 45) who has heavy, manual-type
work for this procedure. They are better off with fusion surgery.
Q: How does a typical procedure progress?
A: The procedure involves taking out the arthritic thumb bone (the trapezius),
and use the patient's own tissue (the FCR tendon) to reconstruct the
joint and create the new joint cushion.
Q: What’s the typical recovery time and is physical therapy part of
the usual protocol?
A: The patient typically will be in a small cast that holds the thumb immobile
for about six weeks to protect the reconstruction, then out of the cast
to start gentle use and participate in once a week therapy for another
six weeks. Usually there is complete and normal use of the thumb at three
months from surgery.
Q: What risks are associated with the surgery?
A: Risks include tendon injury, vascular injury and possible infection. They
are very rare, but the LRTI procedure is quite technically demanding and
should only be performed by a board certified and fellowship trained hand surgeon.
Ying Chi, M.D