Innovative thumb joint replacement surgery

Similar to getting a new knee or hip to relieve severe arthritis, a growing number of people are getting a thumb joint replacement.

The surgery itself is very intricate because of the small space.

WINK News health and medical reporter Amy Oshier shows us how a local surgeon uses a tendon from the patient’s wrist to rebuild their worn-out joint.

With a career that ties him to his computer, there’s a lot riding on Joe Goldstein’s thumbs. After years of typing, not to mention sports, both his joints were shot.

Goldstein said, “The pain in my hands would get so bad that I would not be able to do some basic functions. I couldn’t open a can.”

It stems from arthritis at the base of the thumb, and it’s more common today as our thumbs shoulder a lot of weight.

Dr. Dennis Sagini, Fort Myers orthopedic hand surgeon at Precision Healthcare Specialists, said, “We’re using devices that require the use of our hands. We start using computers, and we start using phones as children, and the thumb is required for the use of many of these devices that we use. You’re applying pressure at the base of your thumb throughout your daily life, throughout work, your work life [and] throughout your leisure life.”

Sagini sees cases like Goldstein’s every day. The wear and tear only gets worse over time.

“I started getting shots, and the injections worked for about two to three years. The first injections would last for six or eight months, and then slowly, they would not last as long,” Goldstein said.

A long-term solution is a thumb joint replacement. Unlike other replacements, it doesn’t require an artificial joint. Instead, Dr. Sagini takes a tendon from the wrist and performs a complex operation to remove the bony joint and rebuild a new one with the tendon.

“The tendon is actually rolled into a cushion that serves as the joint replacement, and so we roll the tendon into almost like a pillow, and we use a special suture to keep it in that form, and then scar forms around the tendon, and that results in it maintaining its shape and position,” Sagini said.

Goldstein’s arthritis was so bad that he had both thumbs replaced, and he is glad he did.

“Eventually, my hands would probably not have been functional if I had not taken some sort of action,” he said.

Sagini said, What’s nice about that is you don’t have a foreign material in your body, and that reduces the risk of things like infection and mechanical breakdown.”

With no parts to wear out, this surgery should last a lifetime.

The surgery requires a period of splinting and immobilizing the thumb while it heals.

Then, physical therapy. This is standard after any joint replacement.

Patients have about 40% of their strength back in about three months, and it will continue to improve.

Goldstein said he’s at about 80% of his pre-arthritis strength.