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CMC Arthroplasty with Artelon Spacer Expand / Collapse
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Posted Saturday, May 30, 2009 5:34 PM


 

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I'm really glad to find this forum! My thumbs, especially my left, are getting worse by the day, and I often wear small braces all day long now. But after reading these posts, I wonder if I should just keep on doing that and skip the surgery. But they really do hurt and are limiting my activities. The hand specialist at University of Va. Medical Center told me two years ago when I consulted him that he was keeping his eye on a new procedure that involved sliding the thumb tendon down and tacking it in place. He told me to check back with him to see if he ended up doing that, but when I called last week, his nurse said it wasn't a success, so he's still doing the standard tendon surgery. Any advice for me? Should I just tough it out and wear my attractive braces for the duration?
Post #4206281
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Posted Saturday, May 30, 2009 11:12 PM


 

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Hi Barbara,

I find it difficult to suggest the type of treatment for you.  I know what my pain level is and how much I can handle.  But, I don't know the exact pain you are feeling or how much you can handle.   My only comments are towards the actual surgeries themselves.  The tendon surgery has had some success, but you will lose some strength.  I had the joint replaced, the surgery failed because the joint is not stable.  I can still move the joint and my pain level is low. That is if I don't use it very much. 

The other post mention the Artelon Spacer, from the reviews I have read and some other research on the web this procedure is not having great success. 

I know it sounds very gloom and doom, but they are working on another type of artificial joint.  This is what I am holding out for.  I wear my braces (both hands) and take my medication when the pain gets bad.

You have to determine when enough is enough.  Every one of these procedures has the possibility of relieving pain.  Some individuals experience great pain relief and others don't.   

If you are not sure I would recommend a second or third opinion from other hand specialist.

Good Luck and take care,

Scott

Post #4206306
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Posted Monday, June 01, 2009 2:06 PM


 

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WOW Elmer!  Sure glad all is well now.  Doing well so far.  Sure wish I had the tendon procedure that was done on my right hand done on my left.  Like all of us, The Artelon spacer made sense.  I have an ache still when I try to apply pressure with my left hand.  At times I will feel it when I play golf, not always.  It's just something I will have to live with.  All the white lightening pain is gone.  So that is a real plus for both hands.  Shot a 90 yesterday.  So life is good

Now I'm working on getting orthotics for my poor feet.  Have an appointment this after noon with a foot doctor.  Know when he sees my twisted toes that he'll want to do surgery.  Well, not for along time.  There is no white lightening pain.

Hope all our artelons are doing well.  Wish some of the oldies would report in.

Kieye

Post #4206508
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Posted Monday, June 29, 2009 8:21 PM


 

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I'M REALLY HAVING A HARD TIME USING THIS SITE.

Elmer- thankgoodness all is better, and Kieye- how are your feet???

I'm taking Celebrex for my knees, and it's helping tons. The thumb is somewhat better with Celebrex.

I called the Artelon Co to see what statistics they had re problems, and what actions are recommended. They say they don't have a reporting mechanism for collecting this data. My Dr had told me he only had good outcomes for pain relief- no other pt had reported strength loss or more pain post op [the lightening stabs of pain ARE gone]- he wants to see me again, but I can't think of what he'd do. I had cortisone and "needling" to break up scar tissue in case that was it. [ouch] That didn't help. So I haven't scheduled the 4 hr drive to the office- still thinking abt it.

penny

Post #4213519
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Posted Wednesday, July 01, 2009 3:28 PM


 

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Received my orthothics.  I'm very surprised that it will fit in a few of my closed top shoes.  I was inforned that it only will go in lace shoes.  I will probaly have to go for some therapy on my heel.  The doctor said that I did have tendonitis and may go away by having my feet placed in the right form for walking.  So I'll wait awhile on the therapy.

Sorry to hear you are still having a great deal of pain with the spacer.  I'm glad I went with the tendon procedure the second time on my right hand - all is well still.   I'm not in alot of pain with the artelon with my left hand, but I KNOW IT'S THERE.  I just worry that it will get worse, like it was before surgery.

With your pain, I would seek another opinion.  I know you don't want surgery again - WHO DOES?, but you can have the tendon procedure.

Kieye

Post #4213837
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Posted Tuesday, July 07, 2009 12:56 PM


 

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Hi, I am an attorney who handles product liability cases.  I have a contact in the medical device industry who asked me to look at the Artelon Implant.  I was shocked to see so many of you having problems with the implant and reading about doctors not doing them anymore.  I don't know if there is a problem with these implants or not, but I would like to hear your stories.  Please contact me at my direct email: jkincannon@keefebartels.com.  Good luck to everyone on this thread and thanks to the webmaster for making such an informative site.

Josh Kincannon

Post #4214805
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Posted Wednesday, July 08, 2009 6:17 AM


 

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I have found something that may be of tremendous help for those who had the CMC artimplant and yet have pain / weakness. Ten months out from my right (dominant) CMC artimplant, I had weakness and pain with use that wasn't much of an improvement from pre-surgery. I went to a licensed medical massage therapist. The first massage hurt like crazy, but the next day I had noticeable improvement in both pain and function. I continued twice a week for a month. I now have a fully functional hand, minimal discomfort and it's getting better each week. I reported this to my doctor, who was a physical therapist in her former life, and she was very impressed-- asked for my massage therapist's name and number. I can't emphasize how much of a difference this has made for me. It seems that it was all about adhesions, scar tissue and tissue thickening that created chronic problems. I highly recommend this for anyone who doesn't seem to be progressing anymore and still has less than satisfactory results following CMC artimplant arthroplasty. Just for clarification, this isn't 'Swedish' massage by any means. It's uncomfortable, it often causes bruising. But then scar tissue and adhesions are tough and require more than a little effort to break down. I am so glad I no longer have to worry about whether I should wait it out longer or just go in for a revision (LRTI). If you want to try this, please give it more than one or two visits, and be prepared for the discomfort during the massage. In my case, I saw results the very first visit. And, it's covered by most insurance policies. You may be glad you tried this if you are considering a revision.

Patti, M.S.N, CRNA
Post #4215022
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Posted Friday, July 10, 2009 9:14 PM


 

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Please see my post regarding medical massage following CMC artimplant surgery. The artimplant is usually reserved for the relatively young patient who has no other significant arthritic changes beyond the CMC joint. Unfortunately, this is the same population that will more easily form scar tissue as compared to older patients. With me, I'm in my forties, have no other hand arthritis, and developed much internal scarring from not just surgery but the weeks of immobility that followed. I was amazed at how glued together my hand muscles (located in the forearm) were and how much they improved following deep tissue massage from my fingertips to my elbow. My palm is flatter, I can rotate my thumb in a circle with little or no discomfort, and my pinch strength has returned. It pretty much feels like my former healthy, pre-arthritic hand. As an anesthetist, I rely on the heavy use of my hands every day, all day long-- yet I feel much more confident about having my left hand done now that I know how well the adhesions and scar tissue respond to manual therapy. Hope this is helpful for you-- best wishes.

Patti, MSN, CRNA
Post #4215688
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Posted Tuesday, July 21, 2009 10:29 PM


 

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Hi- Thanks for this terrific info. I feel the problem is with scarring [it was hot there for more than 5 mo!] There is nothing out of place, and no further arthritis- plus the arthritic bone was removed, so what else could it be? I too had a great deal of trouble rehabbing my wrist, which seemed all glued together from immobilization- even though I never had a cast, only removable splint which I took off twice a day to care for an infected pin- do pin site care. At this time I moved my wrist through ROM being super careful not to move the thumb. So I do think breaking up adhesions through massage is a good idea. I'll let you know what happens.
Post #4218784
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Posted Monday, August 17, 2009 10:57 AM


 

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I had spacers put in both thumbs. The left one going on three years, the right one going on two years. The left one is okay, some discomfort at times, but not too bad. The right one is a different story. The doctor just put a split on it recently because of inflamed tendons in my wrist. I've had growths/cysts near each thumb. The doctor drained the left one two or three times, and the growth went away. He drained the one on the right hand several times but then stopped because there wasn't much fluid present; the growth/cyst hasn't gone away. The inflamed tendons are right next to the growth/cyst. The doctor no longer performs this procedure. He wants to operate again and fuse it. I'm frustrated. What have people found out about the negative drawbacks of spacers?
John
Post #4225770
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Posted Thursday, August 20, 2009 5:32 PM


 

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I wrote on here earlier and have been contacted by some of you regarding your problems with the Artelon CMC Spacer.  Please if you are reading this and have a similar experience email me.  If you have a doctor who will no longer do the Artelon surgery, please let me know.  I just learned about the problem with the bone shaving and others have told me some very troubling experiences that they have had.  I know some people have had good results, which is great, I wish everybody and happy and quick recovery.  But I am still surprised at how many people are having problems after a year or so.  My email is JKincannon@keefebartels.com.  I work everyday with people who have had problems with medical device implants, primarily knees and hips.  That website is www.defectivejoints.com, you can see that I am for real.  Thanks to everyone on this site who takes the time to share their experiences for the benefit of everyone else.  Good luck to you all!

Josh

Post #4226513
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Posted Wednesday, September 09, 2009 8:19 PM


 

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I went to see my doctor today. It's going on two years since I had the spacer put in. He wants to operate again, using the procedure where he'll use a tendon from my wrist and wrap it around my thumb joint. I don't want surgery again, but, I want to know how others have fared when having the tendon replacement as compared to fusion?
Thanks,
John
Post #4231668
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Posted Tuesday, September 22, 2009 10:59 AM


 

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So in other words Josh, you're an ambulance chaser...
Post #4236075
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Posted Wednesday, September 23, 2009 10:08 PM


 

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Hi, I've been reading the posts for awhile now while comtemplating my surgery set for 9/30. It scares me to think of how things could get screwed up worse. My doctor originally wanted to use the spacer, but I didn't want to have to redo it if it didn't work so I am going for the tendon way instead. It seems there are a lot of unhappy campers with the spacer so I think I am making the right choice, but who knows??
Post #4236930
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Posted Sunday, October 04, 2009 9:29 PM


 

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I saw my surgeon re complaint of pain that never stopped post op-see previous posts above. He xrayed. There are no changes since the surg- space ok and no further arthritis. I went back to therapy. [had tried massage to break up scar tissue for 3 visits without improvement.] The therapist felt crepitus and said I'm losing my web space... but my thumb was pinned slightly behind the index finger post op- I never regained the preop space. The Dr said he was very pleased at the range of motion and never expected me to have other than "a functional" thumb. However, I only have a marginally functional thumb due to strength loss and discomfort with activities- therapist measured strength. He's trying E stim, ultrasound, hot packs, and will add strenghtening. I go 2x/ wk.

As to litigation, I feel it was a new procedure. The DR was careful. He still denies others have had this problem in his practice. No Dr can guarantee the outcome, only tell you the risks.

As to the tendon procedure, it has a long recovery of about a year... I'm 2 yrs out, so haven't recovered any faster, which was the original idea. You can visit the posts of the thumb surgery group to see if this procedure would better meet your needs.

Post #4240999
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Posted Monday, October 05, 2009 10:37 AM


 

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Penelope, I disagree with you on the long recovery time with the tendon Ligament procedure.  My first surgery on my left hand was with the artelon/ some tendon- have occassional pain.  My right hand was with the tendon totally- no pain  I was golfting in 4 months.  Will never have full strength with both hands- no hand surgery will give you this yet.  My surgeon told me this.  But I will have funtional hands.  The one done with total tendon is my best hand. Sure wish my my left hand was done that way.  But the pain isn't that great and I wear a soft brace when golfing.

Kieye 

Post #4241102
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Posted Saturday, October 10, 2009 11:01 AM


 

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Hi Kieye,

Thanks for the input re recovery time with the anchovy procedure... Golfing after 4 mo is GREAT!

Re strength- did you lose the strength you had pre op?  I did, and was not expecting that from what the Dr had told me pre op.  I don't feel I should have lost preop strength. The DR said the reason for the surg was to relieve pain. I still have almost constant achyness to pain. It usually isn't the lightening type of preop. The therapist said I should think abt the anchovy procedure.

Does anyone know what the %'s are on pain relief with this procedure?

penny

Post #4242973
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Posted Friday, October 16, 2009 9:47 AM


 

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Hello, everybody! Still having problems with the Artelon procedure in both thumbs. I went to a new surgeon yesterday and he told me the same thing the surgeon who did the Artelon said: I need to have both thumbs redone with the LRTI. My body has evidently rejected the Artelon and is "attacking" the bone - especially in my left thumb. Three doctors have now told me that fusion is out of the question. Anyway, gonna have one LRTI done in December and the other one done next summer. I'm really not happy about the Artelon thing, but what are you gonna do? Better to have loved and lost, etc., etc...
Post #4245633
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Posted Friday, October 16, 2009 4:03 PM


 

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Elmer, sorry you have to have your hands done again. What a bummer. We all thought the artelon spacer made sense, a good bone doesn't have to come out like in the LRTI procedure. Sure hope you come out as well as I did when I had the LRTI done on my right thumb.

Penelope, My doctor told me on the first visit with him that surgeons have been doing surgery on the thumb for 30 yrs and they have yet perfected it. By having the surgery, you are hoping to eliminate all or half the pain to improve mobility. He did not paint a beautiful-wonderful picture, that all will be be perfect. My surgeon is a teaching doctor at one of our biggest hospitals in Mich. He was honest and one can read this honesty he stated here on the boards. The surgery on the thumb has yet to be perfected. I'm doing well, but my hands will never be as they used to be. At least I don't have that white lightening pain 24 hrs continious and I can play golf.

Kieye
Post #4245835
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Posted Friday, October 16, 2009 9:45 PM


 

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Hi guys. I've been reading your posts for months and am glad to see some more of the regulars checking back in again. I just had the LRTI procedure done on my dominant hand on sept 30. I had the stitches out on 10/15 and still have 2 ugly pins under the bandages. I'm hoping to have the same success as you Kieye and I wish Elmer well on his future surgery. This website tells it like it is and really let me know what to expect. I think my hand is hurting more now that the stitches are out than before.
Post #4245985
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