Gardening. Golfing. Even putting away the dishes became difficult for Marilyn several years ago, and that’s when she decided to seek out a hand specialist in Orlando. Today, she is back doing what she loves, and she owes it all to a missing bone.
Marilyn has always had a love of writing; so, when it became too painful for her to put pen to paper she scheduled an appointment with Alan W. Christensen, M.D., a hand specialist at Orlando Orthopaedic Center.
After their initial consultation, Dr. Christensen suggested several options to help relieve her pain, offering the pros and cons for each option.
Together, the duo decided excision arthroplasty was the best way to give Marilyn back the function she wanted.
“I really appreciated how honest he was, and he even told me to go home and do research on my own before making a decision,” she says. “I trusted his judgment and went ahead and did [the surgery] and it has been great.”
In fact, Marilyn was playing golf again just five weeks after her procedure.
“Surgery really has made a profound impact on my life,” she says. “[It] really helped me be able to function.”
What is an Excision Arhroplasty?
Essentially, an excision arthroplasty removes the trapezium, a small bone situated between the two large bones at the base of the thumb, and replaces it with a piece of tendon, preventing the surfaces of the joints from rubbing together. When these joints rub together, there’s a sudden, intense pain, making it difficult to perform even menial tasks like typing or holding a glass of water.
The result of surgery?
“The tendon provides soft tissue that forms a sort of false joint to maintain the thumbs ability to move,” says Dr. Christensen. “This false joint alleviates the pain by preventing the surfaces of the joints from being rubbed together.”
He says the problem arises when the carpometacarpal (CMC) joint of the thumb becomes attached to the trapezium bone in the wrist. The CMC joint is what allows a person to move the thumb to the palm.
The goal of the 90-minute excision arthroplasty procedure is to ease the pain where those two joint surfaces now rub together. The tendon forms a soft tissue “spacer” that will separate the surfaces of the CMC joint.
“An excision arthroplasty will alleviate pain while allowing the thumb joint to retain a level of movement,” he says. “This is unlike a fusion surgery which binds the joint together and causes it to be immobile.”
Recovering from an Excision Arthroplasty
Following surgery, Dr. Christensen performs a follow up in five to seven days to check on healing. Patients will wear a thumb brace for four to six weeks to give the hand time to heal. Patients are then directed to attend physical therapy sessions for several weeks as they begin to regain strength, range of motion and motor abilities in their hand.
“The pain level now compared to before I had surgery is as different as night and day,” says Marilyn. “I’m back writing full-time and playing golf and it has really made a big difference.”
Dr. Christensen notes that full recovery may take up to four months in some patients, but many begin going back to their regular activities much sooner.
“For me this surgery was fantastic,” says Marilyn. “I love the results.”
By Corey Gehrold