LRTI Surgery for Basal Joint Arthritis

[nodamidis]

I had Ligament Reconstruction Tendon Interposition (LRTI) surgery about a month ago to treat basal joint arthritis in my thumb.  I am still having pain in the basal joint area and was wondering if there is anyone here who has had the same surgery and can tell me whether that is normal during the long recovery period.  I have an appointment with my surgeon in a couple of weeks, but I would love to talk to someone else who has had the procedure.  I

[Blueraven60]

I had significant pain for about 6 months, though paraffin soaks helped a lot!

[easternshore]

i am 4 weeks post op LRTI on my left ( non dominate) thumb, was in a soft cast ace bandage 1st two weeks, fiberglass cast 2 weeks ago with 2 more weeks until its removal.  i found the pain quite acute, 8-9 on a 1-10 scale and needed additional percocet for the pain.  Pain is random, thumb joint, arm incision, and general soreness.  trade off is 2-3 months of pain for 15-20 yrs pain free.  i have a low pain tolerance but "mild discomfort" was a gross understatement of the actual pain. i found sleeping easier with my arm propped up with pillows.  if you are going to elect this surgery buy a good arm sling from amazon as the sling you'll be given will be uncomfortable and keeping your arm in a sling will be a big help.  

[CraftingCrofter]

Yes, I was given splints to supposedly protect the joints from worsening before surgery. While they did allow me to do more with less pain initially, they did not keep things from worsening. In fact, I started getting new pain...I think they allowed things to weaken or loosen. The pain specialist who gave me cortisone injections guessed it was something catching on the bone spurs.
The injections helped with some pain, but not that catching. I stopped wearing the splints so much and that catching pain went away (even in the hand that did not get injections).  By the third injection it no longer gave any relief from the aching or general pain when using my thumb, so I went ahead with LRTI surgery 3 days ago.
I am in a splint now until stitches come out, then will have a cast, then a removable splint. I am surprised that I don't have much pain right now. I have not taken any of the Rx yet, only a Tylenol twice for some twinging. That might be nerves waking up, so it might get worse. I am using an arm elevation pillow, Carter type, which is a block of foam that keeps my arm pointing to the ceiling, and I think that really helps. I don't see any swelling in my fingers. I am also moving my fingers lots as per doctor's orders. I was surprised that I do feel some stiffness at the base of all my fingers, but the moving seems to be helping.

[Kjmurillo]

I have basal joint arthritis in my right thumb. Went to a arthritis specialist with my e X-rays that my primary dr ordered. The arthritis dr did shoot some cortisone into the area and I did get some relief and I returned to him in a couple of weeks. He pushed and pushed my thumb untill I told him to stop as it hurt like hell. He then told me it was my tendons and I needed to go to pain management therapy. I asked him if he ever looked at my X-rays and he said no. I have had osteo arthritis in my joints for years so I was not convinced that it was my tendons causing the pain in my thumb. So yesterday I went to see a hand specialist who told me to look up the lrti surgery and he showed me my X-rays which is bone on bone with a bone spur attached. He suggested I wear a splint on my thumb firstl and was suffled out of the office. Has anyone here worn a splint befor having the surgery? And if so how long did you wear it befor you had the surgery. To me it's like putting a bandage over it but not fixing it.

[Javalover123]

I am currently 4 wks and 2 days out of LRTI on my right, dominant, hand.  The pain relating to the surgery was a little more than I expected but the most frustrating part is that no one really tells you what to expect after surgery, after pin removal, cast removal and going to occupational therapy.  I have worked in a PT and OT clinic for over 12 years and I will tell you that you MUST see an OT versus a PT.  PT's are therapists that treat gross motor, like legs, back and OT's treat fine motor such as hands and fingers.  I have had 2 OT therapy sessions and I know my participation in this and my home exercises is crucial in my recovery.  I also suffer from depression and anxiety and live alone.  Not only did I have this on my right hand I have it on my left.  My right hand carpal tunnel was much worse than the left were as the left hand arthritis, subluxation and bone spurs is worse on my left.  It was a toss up of which to do first.  Trying to manage daily tasks, go to work with only my left hand has made the pain in that hand  excruciating at best.  I have been allergic to every narcotic I have been given and am having to rely on Nsaid's Tylenol to manage pain.  If I had know this was going to take 3 or more months of therapy before I can really use my hand I would have planned different, staying with family.  This has not deterred me from having my left hand done since the pain in my left hand is so bad that what I am dealing with on my right is a piece of cake.  Advice - talk to doctor, therapist, family before you have this type of surgery done.  Be FULLY aware of what  will be the next several months of your life.

[DCWNM]

Hello John

I am considering on having this surgery an would like to know if you went through with it. I also play guitar and when I do I have to take a pain pill before and after which is only about 4 hours apart or I don't even want to drive home.

If you had the surgery please let me know how it went and how your recovery is going.

Thanks and have a good day,
Dan

[DrSpencer]

No. Basal JOINT arthritis is inflammation of the joint at the base of the digit. Basal CELL carcinoma is malignancy of the basal cells of the skin.

[WWfromBorneo]

I had LRTI surgery, trigger thumb release and index finger fusion on my left and non- dominant hand on Sept 29 2015 in Kuala Lumpur, Malaysia by a UK/US trained hand micro surgeon. On Feb 16 2016 I had an LRTI surgery and index finger fusion on my dominant right hand - so I am now 6 days post op. This surgeon has some very progressive ideas on physiotherapy and recovery regime- my left hand is now 4 and a half months post op and I have no pain, full range of movement, good strength and pinch.
On both occasions my physiotherapy started the day after surgery! I wear a hard shell removable 3/4 cast on my hand and a protective hard shell cast on my fused finger. I remove the hand cast myself to massage and ice my hand and arm twice a day. I have physiotherapy 3 times a week where the thumb is passively moved and the hand and arm ( where the tendon was taken) are massaged and given ultrasound. My stitches are at the 2 areas where the  tendon was removed and a small v where the trapezium bone was removed- they will be removed 2 weeks post op. The swelling has reduced significantly and this time I don't even have a numb section on the top of my thumb. The pain is only about 1 on a scale of 1-10 and I take a maximum of 2 Advil and 2 Tylenol tablets a day if needed and have been prescribed antibiotics for 10 days. This regime is so unlike what would happen in my home country where I would be in a fixed cast for 8-12 weeks. A very unique approach but one which for me has worked amazingly well- worth thinking about if you can find a hand microsurgeon willing to perform it.

[dooner3]

I'm 10 days out from surgery on my left thumb.  Had an arm block before the surgery  and sailed through.  1 day on vicodon ( I hate the stuff - makes me nauseous, but knocked me out and made me forget about the pain).  Next day 2 days took one Naproxen.  Getting the stitches out tomorrow and will be in a removable cast (have a half cast now).  My pain is not horrid and I certainly don't need meds for it, as long as I am in the splint and not moving it.  Area hurts to touch.  Tendons in my forearm have locked up a few times and that is painful, but I rubbed them out.  Some shooting pains near the joint area on occasion.    Looking forward to therapy and being done with the casts. It will be a long process, but I'm a trooper and will get through it and be happier on the other side, I hope!

[Tuckamore]

Please begin new thread and share you information.

"Old people"??? There are better terms and that is not very descriptive. Arthritis can occur at any age. There is juvenile arthritis that strikes  300,000 of our children under the age of 16.

Juvenile arthritis (JA) is not a disease in itself. Also known as pediatric rheumatic disease, JA is an umbrella term used to describe the many autoimmune and inflammatory conditions or pediatric rheumatic diseases that can develop in children under the age of 16.

Arthritis - both RA and Osteo can strike at any age. Most practitioners will say that once you reach 50 you have some form and some degree of degeneration of joints and often arthritis sets in.

Thanks for your input.
~Tuck

[Tuckamore]

Sorry - I am not seeing any recent activity from the last two posters. In order to reach them you might try leaving a note on their Profile Pages.

If a member selects the option to be notified of notes and messages they may see yours and respond. Sorry I can't do better for you.

If you'd like to begin a discussion, ask questions or make comments please begin a new thread. You'll get better visibility and most likely more responses. This is a very old thread and belongs to another person. Your participation is important to us.

Thanks,
~Tuck

[Babikaso]

How long do I have to wear the splint, after surgery

[SusyinFlorida]

I am almost 6 weeks post op on left dominant hand.  I started physio at 4 1/2 weeks, so have been about 4 times. Docs will not give me pain meds, but did put me on Prednisone to reduce swelling.  Must say this is all very brutal both physically and mentally.  I use "pain meditation" CD's that help, lots of microwave hot paks.  About 3 times a day I fill up the sink with very hot water and start my exercises in there, then move to the table.  I am only taking Tylenol.  Good news is that recent xrays showed all surgical aspects to be in place.  Now, I'll just be patient and do the work.  I started driving again yesterday.  Must say that my hand is of none to little use right now, although I am typing with it.  Probably good exercise.  Since you are close to me in time, stay in touch.  P.S. I am 68.

[Sharoname]

I am 7 days post op from a LRTI Arthroplaxty on my left thumb. My ortho must believe in fast track. I started with a soft 1/2 hard cast and on the 3rd day of post op met with physical therapist who removed cast and replaced with hard 1/2 removable splint cast. I've been on pain meds and know I need them for at least another week. The pain is great after this surgery and I keep telling myself this. Will all be worth it in 10 months or so. It just seems so far away. Does anyone else who has had this surgery been to physical therapy so soon after surgery? From what I have researched most people have had to wait usually 2-3 weeks and after stitches are removed to start therapy. How long has your physicians prescribed pain medication for you after this surgery? Any info would help. I trying to wrap my head around all this pain I'm in.

[Pearllee]

Hello: I'm also in my 10th week out, but my pain is still there. I've been in therapy once a week for three weeks now. I really thought I was doing great. I have lots of strength and can lift a gallon of milk and pour with no problem. My pinch strength is good also. Back to the pain, it never stops and is lots worse after the therapy. It takes me three days afterwards before I can use it again without a lot of pain. I know it takes some people longer and I am 65 yrs old, just hoping it goes away soon. I'm glad you are doing great. Thanks for listening

[Jolof]

Thank you!! There is a physical therapist office with a hand specialist in the office across the hall from my doctor. I will be going there. Thanks again for the information

[Donamia]

Hello:  I'm entering my 10th post-operative LRPTI recovery month and I'm pain free with a full range of motion for the first time in over ten years.  Please be selective with your choice of rehab-therapist.  My doctor insisted that I see a Certified Hand Specialist as they have the tools, knowledge and skills to deal with the complicated workings of the hand.  You will be looking forward to your therapy visits as they will provide the assistance you'll need on this part of your journey.  Pain is what motivated me to seek a permanent cure.  The pain after surgery is now a dull memory and was certainly worth it .  Wishing you a superb recovery

[Jolof]

I am 4 weeks out from this surgery. I have the cast on for 2 more weeks. The joint is painful, just not as much as after the surgery. I take a hydrocodone at night and another midmorning. I take an 800 ibuprofen first thing in the morning then 8 hours later. I still put an ice pack on every few hours. Not looking forward to the physical therapy!  But I know it will be better eventually and I will not have the pain in the joint as before surgery.

[Mammyof8]

I, too, am about 7 weeks post surgery.  I think the pain  is normal due to the fact that everything in the basil joint area was cut, removed, poked, pulled, cleaned up, reconstructed, stitched and probably a number on thing done to it that we might not want to know about.  This is a surgery that has a long recovery period (I've read it can be as long as 6 months) so don't get discouraged.  Talk to you doctor about using ibuprofen between doses of Hydrocodone.  I have found this to be very helpful with pain management.  Also, alternate hot and cold compresses.  Hope this helps.

[2angel]

I had an LRTI 6 1/2 weeks ago and it is so painful. I wore a hard splint for the 1st 2 weeks, a cast for the next 4 weeks and I am now in a removal thumb spika splint. I take it off to do the 2 exercises they want me to do. I am not too successful at moving my thumb in the direction they would like me to. I still swell off and on but a cold pack seems to help that. I feel significant pain most of the time; I do have hydrocodone to manage the pain but cannot take it as often as necessary because it makes me sleepy and I have responsibilities to tend to. At this point I am feeling frustrated that I cannot use that hand as much as I thought I would be able to. I really need my hand back!! I do not know if the pain in the thumb joint is normal at this stage but just like you I have pain.

[Ginger2981]

I just had an LRTI after having three bones removed from my wrist.  Im now 4 1/2 months out and my thumb keeps rolling toward my palm. With my exercising the base of my thumb kicks in and is painful.  He Dr. Said there is really nothing more to do short of fusing my wrist.  It just seems like it's the thumb that is loose.  Please help

[Sfreeman335]

Hi john, I am a professional guitar player and need this surgery, how did yours turn out?I am curious about the healing and how long it took to get your chops back

[JohnChristopherBayman]

I am a professional guitarist, pianist, bassist, and private teacher, and am needing this operation.  I guess I don't see anyway around it, but does anyone have experience with these instruments post-op?  My surgeon tells me that I have tendonitis, and carpal tunnel, and wants to do all three surgeries at the same time--seems frightening.  I am a 53 yr.-old male, and any comments or help in understanding this procedure would be much appreciated!  Thank-you.

[Skippygirl]

I had LRTI surgery on my left thumb nearly 3 years ago and am fixin to have it on my right thumb in about a month.  While it took a good 3 to 4 months recovery time and then still longer to slowly regain strength, it was the BEST thing I could have done.  Being right handed, I realize this next surgery will be tougher in that it will be more difficult to do things while in a cast but it is definitely a means to an end - that end being free from the constant pain.  You will probably not regain all of your fingertip strength after having this done, but when you are in so much pain beforehand, you don't have much strength anyway.  Good luck!!!  After it's all said and done, I think you'll be glad you did it.  I was!!