cmc joint replacement

dollyd,

CMCJ (carpometacarpal joint) surgery is usually done only on the thumb (rarely on the small finger CMCJ).

There are several options for thumb CMCJ arthritis. What procedure is chosen depends upon the patient's underlying condition (osteoarthritis vs an inflammatory arthritis) and demands on the hand.

There are the many variations of the LRTI (ligament reconstruction, tendon interpositional) arthroplasty, which does not use a joint prosthesis.

There have been several different types of artificial replacements designed for the thumb CMCJ in the past several years. Some of the first ones basically consisted of a spherical metal ball that was put in place of the joint. Since then, several others have come out. They are made of different materials, such as metal, silicone, or graphite composite.

Surgery is basically done for pain control, not to increase function. However, if pain is decreased, most patients will have better function. But, function is not the primary indication for joint replacement. And of course, all surgery carries risks. But, the vast majority of patients who have one of these procedures done are happy with the results. They do take a significant amount of post-op occupational therapy to get the best results.

Again, which one is chosen depends upon several factors. You should speak with your hand surgeon concerning which type would be best for your particular situation.

Good luck.

Gaelic, thanks for reply.What has happened is that i have been diagnosed as having oa in the top or RT joint of both my thumbs and was told that they could do an operation on that joint to help my condition and hopefully give my hands some extra working life so i agreed to this and had the operation last year. When they took the plaster off 4 weeks after the op i discovered that they had operated not on my RT joint but on the lower CMC joint. i have been in chronic pain ever since and consequently have been unable to return to work. The hospital cannot give me a good enough reason to why they have operated on this joint instead of the one that they themselves diagnosed where they had discovered osteoarthritis. They now tell me there is an op that can be performed on the RT joint!I am as you can imagine at a loss as to how to proceed. Dollyd

dollyd,

Sorry, but I'm not quite sure what you mean by RT joint.

The joints of the thumb are, starting proximally, the CMCJ, the MCPJ (metacarpophalangeal joint), and the IPJ (interphalangeal joint).


Don't know why the surgeon would operate on the incorrect joint. Did you look at the consent form and surgical planning sheet? It has to specify specifically which joint is going to be operated upon. If they operated on a joint different that what was specified, then you should inform the surgeon and hospital administration. Wrong site surgery is a very big problem, and the only way for it to be eliminated or reduced, is for it to be identified and acknowledged when it does occur.


While the CMCJ is the most common joint to be involved in OA (osteoarthritis), the other two are also very commonly involved.

Usually, the IPJ is fused, rather than replaced. Some with the MCPJ, it is most commonly fused, rather than replaced. However, in inflammatory disorders, or in patients who have low demands, a prosthesis can be put in (joint replacement).

In cases where the patient has both the CMCJ and MCPJ involved, the MCPJ is fused and the CMCJ is replaced or reconstructed. You cannot ignore the MCJP, or the reconstruction of the CMCJ will fail.


But, this is probably more that you wanted to know. Sorry.


So, again, I have no idea why the surgeon would fix the CMCJ, especially if you were told that the other one was going to be fixed. But, again, you really need to look at the consent form.

If the consent form and the actually operated on site are different, this needs to be indentified and acknowledged. Again, that would be a big issue (wrong site surgery).


Good luck.