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Posts Tagged ‘LRTI’

It’s been 12 days since having a second Ligament Reconstruction Tendon Interposition (LRTI) surgery designed to replace the damaged carpometacarpal (CMC) joint at the base of the thumb. This procedure was on the left thumb – the right side was done in April. Today the cast and sutures were removed (see pic below). During the procedure, the trapezium bone is removed from the wrist and a tendon is harvested from the forearm and rolled up and secured in place of the trapezium. Artificial materials such as metal and plastics tend to be rejected as artificial joints in this area.

Instead of being placed in another cast for 3 weeks, the surgeon placed me in a splint with the notion that periodic, gentle movement of the metacarpophalangeal (MC) joint just above the CMC joint may prevent stiffness and freezing of the joint which would ultimately compromise and damage the replaced CMC joint. This is what has happened with my right thumb which my surgeon and rheumatologist suspects is from RA-induced inflammation since RA isn’t really under control at the moment. My occupational therapist spent considerable time attempting to “unfreeze” the joint to no avail. A procedure to either remove the synovial capsule and surrounding soft tissue or to permanently set the MC joint with screws at a 25 degree angle is being considered once the left thumb heals enough for everyday functioning.

This is my 10th surgery in 10 years since being diagnosed with RA and it’s pretty much a toss up as to the difficulty of recovery between this procedure and cervical (neck) discectomy and fusion surgery. My surgeon says the hands contain many nerve endings and it’s difficult to function without the grip of a hand for such a duration. Occupational therapy will begin around 8-10 weeks.

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