If you have already had surgery for thumb arthritis and your thumb is still painful, you are not alone. Sometimes after the first surgery, the thumb bone can slide too far up. This can cause pain that does not go away.
This article looks at a study that tried to fix that problem. Doctors used a special device called a Mini TightRope to hold the thumb bone in place. Here are three things you should know:
- The Mini TightRope is a device that suspends the thumb bone to stop it from moving upward.
- Six women had this revision surgery, which means a second surgery to fix problems from the first one.
- The surgery helped reduce pain, but did not make all patients completely pain free.
Key Findings at a Glance
- Research shows that revision surgery with the Mini TightRope reduced pain levels in patients with painful thumb bone movement after trapezectomy.
- According to this study, pain at rest dropped from an average of 3.3 to 2.5 on a scale of 1 to 10.
- Studies indicate that thumb strength improved in several patients after revision surgery.
- The Mini TightRope had to be removed in three out of six patients, showing that the device does not work for everyone.
- Medical evidence shows that even with the device, the thumb bone continued to move upward over time.
In this article:
- What is trapezectomy and why does the thumb move up?
- What did this study do?
- Did the surgery reduce pain?
- Did thumb strength get better?
- What happened to the thumb bone over time?
- Were there any problems?
- Frequently Asked Questions
- Conclusion
- Disclaimer
- Article Citation
What is trapezectomy and why does the thumb move up?
Trapezectomy is a surgery for thumb arthritis. Doctors remove a small bone at the base of your thumb. That bone is called the trapezium. When the bone is gone, it creates a space.
After the trapezium is removed, the thumb bone can sometimes slide up into the empty space. This is called proximalisation. It means the bone moves closer to the wrist. When this happens, it can cause pain and make it hard to grip things.
You may be wondering why this matters. When the thumb bone moves too far up, the muscles and tendons do not work as well. This makes your thumb weak and painful.
What did this study do?
According to this study, doctors looked at six women who had pain after their first thumb surgery. The women were about 56 years old on average. They had their first surgery about 25 and a half months before the revision surgery.
The doctors used a device called the Mini TightRope. This device is like a small rope or thread that holds the thumb bone in place. It suspends the bone so it does not slide upward.
Here is where it gets interesting. The doctors measured pain levels before and after the revision surgery. They also measured how strong the thumb was. They took X-rays to see where the thumb bone was located. Then they followed the patients for an average of about 14 months.
Did the surgery reduce pain?
Research shows that the revision surgery did help reduce pain. But no patient became completely pain free. The doctors used a scale from 1 to 10 to measure pain. A score of 1 means very little pain. A score of 10 means the worst pain you can imagine.
Let us look closer at the numbers:
| Activity | Pain Before Surgery | Pain After Surgery |
|---|---|---|
| At rest | 3.3 | 2.5 |
| With mild load | 4.8 | 3.5 |
| With high load | 7.0 | 4.8 |
Mild load means doing light activities like holding a cup. High load means gripping hard or lifting something heavy.
You can see that pain went down in all three situations. The biggest improvement was with high load activities. But even after surgery, some pain remained.
Did thumb strength get better?
According to medical evidence, thumb strength did improve for some patients. The doctors measured how strong the fingertips were compared to the other hand.
Before surgery, five out of six patients had strength below 60 percent of their other hand. After surgery, only two patients were still that weak. Three patients got their strength up to between 80 and 99 percent of their other hand. That is a big improvement.
The doctors also used a scoring system called Buck-Gramcko. This system looks at pain, strength, and how well you can use your thumb. The score can go up to 56 points. Before surgery, the average score was about 11.7 points. After surgery, it went up to 32 points. That is an increase of about 20 points.
What happened to the thumb bone over time?
Here is where it gets a bit disappointing. Right after surgery, the doctors measured the distance between the thumb bone and the wrist bone. The average distance was about 8.3 millimeters. That is a little less than half an inch.
But at the final checkup, the distance had shrunk to about 3.3 millimeters. This means the thumb bone moved upward again by about 5 millimeters. Studies indicate that the Mini TightRope did not stop the thumb from sliding upward over time.
Even though the bone moved up again, most patients still felt better than before the revision surgery.
Were there any problems?
Yes, there were some problems. The Mini TightRope had to be removed in three out of six patients. That is half of the people in the study. Two patients needed another surgery after the revision.
This tells us that the Mini TightRope does not work well for everyone. Some people may have irritation or other issues that make it necessary to take the device out.
What does this mean for you?
If you have had a trapezectomy and your thumb is still painful, you may be thinking about revision surgery. This study shows that the Mini TightRope can help reduce pain and improve strength for some people. But it is not a perfect solution.
You may be wondering why this matters. According to this study, even with the device, your thumb bone may continue to move upward over time. And there is a chance the device may need to be removed.
It is important to talk with your doctor about whether this surgery is right for you. Every person is different. Your doctor can help you understand the risks and benefits.
About this site
This website simplifies medical science for people with thumb pain and rhizarthrosis. We use only published scientific articles. We translate complex research into simple language so you can make informed decisions about your health. We invite you to explore more content on this site to learn about your condition and your options.
Frequently Asked Questions
What is the Mini TightRope?
The Mini TightRope is a small device that holds the thumb bone in place after trapezectomy. It is like a rope or thread that suspends the bone. Doctors use it to try to stop the thumb bone from sliding upward.
Will I be pain free after revision surgery with the Mini TightRope?
Research shows that most patients have less pain after revision surgery. But no patient in this study was completely pain free. Pain levels did go down, especially with heavy activities.
Can the Mini TightRope stop my thumb bone from moving up?
According to this study, the Mini TightRope cannot completely prevent the thumb bone from moving upward over time. Even with the device in place, the thumb bone continued to slide up by an average of 5 millimeters.
How long does it take to recover from revision surgery?
This study followed patients for an average of about 14 months. Recovery time can vary from person to person. Your doctor can give you a better idea based on your situation.
Conclusion
Revision surgery with the Mini TightRope can help reduce pain and improve thumb strength for some people who have painful proximalisation after trapezectomy. But it is not a perfect solution. The device may need to be removed in some cases. And the thumb bone may continue to move upward over time.
If you are dealing with thumb pain after your first surgery, talk to your doctor. Together you can decide if revision surgery is right for you. Remember, every person is different. What works for one person may not work for another.
We hope this article has helped you understand more about this treatment option. You deserve to have all the information you need to make the best choice for your health.
Disclaimer
This article is for informational purposes only. It is not medical advice. Always talk to your doctor before making any decisions about your health or treatment. Your doctor knows your situation best and can give you advice that is right for you.
Article Citation
This blog post is based on the study by Szalay, G., Scheufens, T., Alt, V., Thormann, U., & Heiss, C. (2015). Primary results using the mini TightRope for revision surgery for painful proximalisation of the first metacarpal after trapezectomy for CMC-1-osteoarthritis. Handchir Mikrochir Plast Chir.