CMC Arthroplasty Right Thumb

[jd101861]

Dr. Tomaino, I had a CMC arthroplasty on my right thumb in July 2008. The trapezium bone was removed and a portion of one of my tendons was used in the repair. Since then, the half of the tendon that remained ruptured. In the last two years since the surgery I have suffered pain and weakness. I have had injections, extensive OT with lots of braces, to no avail. I currently have a custom-made brace that works well, but I don't want to have to wear this forever. I need the brace to function, though. Since the 2008 surgery, I was diagnosed with lupus. I had to have the same surgery done on my left thumb in 2002, but in that surgery the trapezium was not excised. I have had good luck with this surgery. Different doctors performed the surgery while I was living in Ohio.

I have consulted two terrific doctors in Michigan and their opinions are different about how to effect the repair. I cannot do the descriptions of what they are proposing justice, but in a nutshell: One doctor wants to pin my thumb on a trial basis, see how it goes, then do a permanent repair. This doctor does not want to use my soft tissue in the repair because of my lupus (previous tendon rupture). The other doctor wants to fuse the joint but has no problem using my soft tissue in the repair. I am hoping you can add your expertise in deciding how best to repair my thumb. Thank you for your help. Jan