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CMC Arthroplasty with Artelon Spacer Expand / Collapse
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Piano Rick
Posted Friday, October 31, 2008 2:22 AM


 

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Just checking in.  No particular change for me.  I'm in the group of you that has less pain now but wish the hand was stronger.  The fusion would never be an option for me unless I decided to surrender my playing career.  I'm glad you have all found your way back to the forum.  It's good to keep exchanging information as many of you are reporting some sort of problem.  The rest of us can be mindful of the reports.

Rick

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Elmer11
Posted Friday, November 07, 2008 9:57 AM


 

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I went to a new doctor in Louisville yesterday and got some disturbing news. I will have to have both thumbs completely reworked with the LRTI procedure. You know how they say that the Artelon spacer doesn't close the door on other procedures? That's BS! It flat slammed it shut on fusion, which was what I was hoping for. The doctor explained to me that a certain amount of bone is shaved off during the Artelon procedure, and that there's not enough bone left to fuse the joint. I knew that some bone was shaved off, but I had no idea it was enough to interfere with any other procedure. This doctor used the Artelon procedure himself until, he said, he saw that nearly 100% of his patients were having problems with it after a year or so. I had really hoped to have the joints fused, so I would retain - or regain - the strength I need; however, it looks like it'll have to be a combination of the LRTI procedure and wearing some sort of brace for the rest of my life anytime I do anything very strenuous with my hands.
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Piano Rick
Posted Friday, November 07, 2008 6:42 PM


 

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That sucks
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penelope
Posted Saturday, November 08, 2008 12:44 PM


 

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I don't know what to say- that's SO dicouraging!

This forum is so hard to find and use,I don't think we'll have many newbies. On another forum I learned my Dr is still doing the arthroscopic Artelon implant and apparently not having patient complaints- maybe I'm the only one?? Still  can't find  failure info on net. If DRs are saying it, they're not publishing their findings.

Penny

Post #4168918
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kieye1
Posted Saturday, November 08, 2008 3:39 PM


 

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That info is a bummer.  I still feel that whatever procedure you have, you'll never regain full strength. My doctor has pretty much comfirmed that.  I will go through the day doing general things shopping, around the house things and my hands are fine.  However, when I try to apply strength to an object like open up a jar, I'll feel pain.  Will wait until the end of January to try and play golf.  That will be the ultimate test for me.

Elmer, I used a cool comfort brace when I was golfing last year.  You can find them on the web or get them through a PT person.  They are soft, flexable and can be washed.

Penny, I feel this board is more forth right  in explaining how the hand feels.  Plus, Most of us are over a year plus with the artelon procedure.  I, also feel that doctors are not publishing what they are seeing, instead they are stopping the precedure.  I've gone to two doctors and they have both stopped using the Artelon.  like my doctor said, "We've been doing joint replacemenst for over 30 years and have yet to come up with an ultimate procedure.

Kieye

Post #4168936
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Elmer11
Posted Monday, November 10, 2008 11:20 AM


 

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I'm afraid you're right. There is no perfect solution for this problem. Artelon was billed (I guess is still being billed) as a means of completely restoring strength and mobility, but it looks like we're not there yet.
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Tom Draina
Posted Friday, November 14, 2008 6:32 PM


 

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Hi, Just chiming in, a little info on my situation. I was involved in a motorcycle accident on Sept 21st, 2006 (person yapping on cell phone ran me off the highway). After being seen by a clueless doctor it was determined that I suffered a crushing injury to my cmc joint. Had surgery 11/28/2008 using the spacer because the doctor stated it had to be done  now or it would no longer be an option. I'm 44 years old and still race motocross and work as a tuner on a race team so grip is vital to me. I'm hoping this works but have reservations about the longevity of the spacer, does anyone have more insight on this, from what I've read it disenagrates after 6 years?
Post #4170153
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kieye1
Posted Tuesday, November 18, 2008 2:54 PM


 

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Tom, I would recommend that you read all the postings on the artelon spacer on this board.  I feel this is the only board that has people with the spacer implant going from 1 yr. to 2 yrs.  It's also the only place where you'll read about the failures and  some doctors no longer are doing this procedure.  All info on the internet talks about the procedure and how it works. But no hard fast data on the plus and minuses.

The Spacer does break down around the 3rd yr and forms with your body tissue.  The tendon arthroplasty procedure does the same thing.

A second opinion should always be considered when doing a joint replacement.

kieye

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Mickey1
Posted Thursday, November 27, 2008 12:38 PM


 

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Kieye1, I have been absent from this forum for a while, and had some free time today so thought I would check in.  Boy, how things have changed over the years!!

In all the research I did, we found that while SBI was doing their trials with only 10 patients, there were 2 patients that rejected the spacer!!  But, did SBI notify Doctors or patients of this?  No, they did not!!  I have found that a lot of the Drs. are not using the spacer due to the problems that the patients are having, some not showing up until 2-3 yrs. after surgery.  So, while it might work for some, there is always the possibility that it won't work for everyone!!

If anyone wants to contact me about any of this, please feel free to do so.  My e-mail addy is: frostyml@hotmail.com

Thanks,

Mickey 1

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Scott1
Posted Tuesday, December 09, 2008 8:59 AM


 

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New reader to the forums.   I will be honest, your replies have scared me.  I currently have an artifical joint in my right CMC and a fusion of my MCP.  The supporting sutures for the artifical joint have failed and it now moves up and down.  I have minimal pain with minimal use.  But, as we all know you can not continue minimal use forever.  If I have 2 to 3 hours of heavy activity I get 3 to 5 days of inflammation and severe pain.   My Orthopedic physician wants to replace the artifical joint with an Artelon Spacer. 

My Doctor's experience is limited to 6 surgeries and he wants to perform the same surgery on my left hand after my right hand heals.   My question/concern is should I go the Artelon route?  The overwhelming responses on this forum paints a very bleak picture.

Post #4174302
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Elmer11
Posted Tuesday, December 09, 2008 12:36 PM


 

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Scott,
All I can offer is my own experience, and I'm afraid it's not very good. I love the whole concept of Artelon, but it just didn't work out in my case. I have an appointment Thursday with the doctor who did both of my thumbs, and I'm going to get his opinion on what I should do next. Actually, I know that he wants to do the LRTI on my right thumb, the one I'm having so much trouble with. I think I would actually be willing to have another Artelon procedure done if he thought there was any chance of its working. But I won't be surprised if I find out he isn't doing the Artelon anymore. I know other doctors who have given up on it. In any event, I'll let everybody know what I find out on Thursday. Would love to hear more from everyone about their current status.
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kieye1
Posted Tuesday, December 09, 2008 3:28 PM


 

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Elmer, hope things go well.  Please let us know what happens on Thurs.  LRtI procedure that was done on my rt. hand is doing well.  With the spacer or the LRTI procedure, we will never regain full strength.  Whats been done is reduce the pain level.  I was hoping like you for better results with the spacer.  The concept made sense.  I just hope the spacer in my left hand doesn't have to be redone.  We'll see when I start golfing again after Xmas.  I know I'll have to wear my braces, I can live with that.  Like with you, it's the pain level.

kieye

Post #4174368
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Elmer11
Posted Friday, December 12, 2008 10:42 AM


 

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Thanks, Kieye! I had an interesting visit with the doctor. He basically said that he thinks Artelon works well with women, but not with men who do too much heavy work with their hands. He first said we could do a new procedure with some sort of polycarbon implant, but then said he would hesitate to use another artificial material and said the LRTI would be the best option. I agreed and told him I'd call today to set a date and all. Then, on the way home, I decided to just put everything on hold. I don't like the finality of the LRTI. So.... For now, I'm going to start wearing my splints and/or braces every day and put off doing anything at all for as long as I can stand it. Maybe I'll start taking glucosamine and develop some new cartilage. ;-) So has anyone heard anything about this new polycarbon implant?
Post #4174756
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kieye1
Posted Friday, December 12, 2008 4:18 PM


 

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Elmer, I don't see the LRTI as being final.  One can still have an artifical implant and lastly fusion.  The thing to remember is, once you decide on the thumb being repaired, one will never have full strength.  One has the surgery to stop the continous white lightening pain.  I've achieved that goal in both hands.  I will not be a jar opener or one to chop wood.  Will find out how well I do playing golf this January.

My second opinion doctor mentioned the polycarbon implant and said that it was not a proven thing yet.

Take your time on making your decision.  You'll know when it's time.

Kieye

Post #4174812
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Elmer11
Posted Saturday, December 13, 2008 8:19 PM


 

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Thanks for the perspective, Kieye! I guess I need to study up more on the LRTI thing, but I just hate the thought of having the bone removed - not to mention the little thing about cutting a piece of tendon out of my wrist! Anyway... I think I can probably tough it out awhile. You're definitely right about the ultimate goal - pain relief. Luckily, my pain is fleeting. I have a great deal of pain when I mess up and do something stupid - like try to squeeze a bottle of honey too hard or something strenuous like that. ;-) I think you referred to it as "white lightning" or something of the sort? But then it's gone and I'm pain-free for the vast majority of the time. I was putting wreaths in our windows earlier today, and had trouble with the sashes sticking; so I had to use my forearms to raise them up rather than my hands. Little things like that are annoying. Oh, well... Like my grandmother used to say, there's nothing so bad but what it could be worse. ;-) It's just that I'm not ready to quit opening jars and chopping wood! It just looks to me like as common as this problem is, that they would come up with a good alternative procedure. But you know what just this minute occurred to me??? Why isn't more research done into the problem? Because the vast majority of sufferers are women. I'll bet you that if most of the people with basal joint arthritis were men, you'd see a lot more money and effort devoted to a solution. grrrrrrrrrrrrrrrrrr Boy, am I rambling now or what? Did I ever tell you I have a raging case of attention def... OH, LOOK! A CHICKEN!!!
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Piano Rick
Posted Friday, December 19, 2008 1:01 AM


 

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Merry Christmas, Happy New Year, Jolly Whatever

Piano Rick

Post #4175626
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KeaC
Posted Monday, December 22, 2008 2:27 PM


 

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Hi Everyone,
I'm the original creator of this particular forum topic a couple of years ago. Haven't checked in for some time...lots has happened related to the thumb/wrist and surgery since then. It has been great to read over many of the posts since then and realize just how many of us have shared similar experiences. Thank goodness for technology and online forums!

A quick recap (or not-so-quick, that's always subjective) of what's happening at my end, as others might benefit...

The original surgery brought wonderful pain relief! The key was to keep up with the PT exercises, to keep the mobility and strength consistent. If the PT lapsed, so did the dexterity and strength decline. Six months later, I was very happy and certain that the artelon spacer was the right decision for my situation.

Ah, but then things started going downhill. The pain returned, slowly but surely. Coordination lessened over time, strength diminished. Carrying a plate of food or glass of water became too painful to do on a regular basis; daily activities were severely impacted. The left hand had to step up to the plate--again--and become the quasi-dominant hand once again, albeit never quite as cooperative or coordinated as the right hand was (alas!). Lots of dropping of utensils, spilling drinks, painful winces, etc. You all know the drill...

The doc said that I should give it more time. Continue with the PT strength exercises, ice/heat treatment when necessary, and use the removeable splint whenever it seemed appropriate. It seemed appropriate more and more often.

This last summer an x-ray revealed that the little wrist bone had a little "finger" of bone growth going towards the metacarpel bone of the thumb. In other words, it was trying to fuse itself to the other bone by growing over the artelon spacer! Weird. So, I was back to feeling "bone on bone" whenever using the thumb...and we all know how wonderful that feels. The solution: remove the trapezius bone. Yes...we're back to that.

So, as of last week, I'm lighter by one trapezius bone. Could have had this done the first time around, 2 years ago, but I gotta say, it was worth the attempt to avoid this "final" solution. The artelon spacer did relieve the pain for a while and does work for a lot of people. My doctor has had much success with this approach; two patients have not done well with it (me being one of them).

Without going into an even longer dissertation about recovery from this particular surgery, let me just say that it is ever so much easier the second time around. You know what to expect. You know what food to buy in advance and what clothes will and won't work. You know how to shower and drive with one hand. Your family knows what to do (and not do). It's just plain easier. Wouldn't be my first choice, given a choice, but none of us were given choices, were we?

For those of you who are considering the artelon spacer surgery, my opinion remains unchanged: it is worth it. If for no other reason, it leaves you with a 2nd option should this one not work out.

I am hopeful that the removal of the trapezius works for me, as there is no 3rd option. Crossing my fingers (left hand, of course).

Enjoy the holidays, folks!
Post #4176080
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Elmer11
Posted Wednesday, December 24, 2008 5:26 PM


 

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Thanks for the update, KeaC! Glad you are doing well. Hope you - and all the other folks on the board - are snug and safe and enjoying the company of friends and family.
Post #4176332
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penelope
Posted Sunday, December 28, 2008 10:06 PM


 

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GOOD TO HEAR FROM YOU GUYS!

I'M 14 1/2 MO OUT ON MY RT, DOMINANT HAND. I DON'T HAVE THE JOINT INSTABILITY I HAD PRE OP, OR THE WHITE LIGHTENING PAIN WITH MOVEMENT, BUT I HAVE CONSTANT LOWGRADE ACHY PAIN AND HAVE LOST STRENGTH IN MY RIGHT HAND. I'M AFRAID  TO ATTEMPT  FURTHER SURGERY -WILL THE PAIN BE WORSE??? FURTHER STRENGTH LOSS??? ALSO, RECOVERY TIME IS SO LONG , AND I DON'T WANT ANY MORE LOSS OF ACTIVTIES- SO I'M GOING TO LIVE WITH IT. MY DR DOESN'T ADMIT TO ANY PROBLEMS WITH ANY OTHER PATIENTS' OUTCOMES. [BADIA, MIAMI] EVERYTHING IS IN PLACE ON MY X-RAYS.

PENNY

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Laurie Daigle
Posted Thursday, January 01, 2009 3:25 PM


 

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I am currently trying to decide between the Artelon spacer and traditional suspension arthroplasty. How did your surgery go?
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