Suspensionplasty, Arthroplasty, Interposition, Intercarpal or Carpometacarpal Joints

Suspensionplasty, Arthroplasty, Interposition. Intercarpal, or Carpometacarpal Joints is an elective procedure that is done to relieve pain and restore function to the joint after damage by arthritis or some other type of trauma. The Intercarpal joints are the articulations between the individual carpal bones. The Carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones Strong ligaments and muscles hold the CMC joint in position and provide stability.

Preoperative

Your health care provider will talk to you about how to prepare for surgery. You may be told not to eat or drink anything after midnight on the day of your surgery. You will be told what medications to take or not take on the day of your surgery before surgery; you will need to obtain clearance from your regular doctor if you have medical problems. You may be required to obtain some basic tests for screening before the surgery. Basic blood tests, a chest x-ray, and an EKG may be required depending on your health.

What happens during Intercarpal, Carpometacarpal Joints surgery

Several surgery options are available. One method is to remove the destroyed joint surfaces, and create a substitute joint:

  • Arthroplasty this procedure requires an incision in the forearm and over the arthritic joint. Almost all surgeries require removal of all or part of the small wrist bone, the trapezium. In most cases, the space created by removing the trapezium will be filled with tendon material, which can be used to suspend and stabilize the base of the first metacarpal so that the reconstructed thumb will regain strength.
  • Suspensionplasty has a favorable outcome for painful osteoarthritis in the carpometacarpal joint of the thumb and that the APL tendon can be removed as a deforming force without any abduction weakness.
  • Osteoarthritis of the thumb carpal metacarpal joint is effectively managed by complete excision of the trapezium or excision of the distal half of the trapezium with maintenance of the space by insertion of interposition tendinous material from palmaris longus or flexor carpi radialis. The more recent modification of partial trapezium excision has improved pinch strength and maintenance of thumb length and so has enhanced the final results. Carpal metacarpal ligament reconstruction is demonstrated because it is occasionally necessary.

How long is the recovery period?

Within three months, restoration of thumb motion begins and pain is diminished. Most normal activities can resume in about six months and even earlier for some patients. Strength recovery takes 3-6 months and improves depending upon the amount of weakness prior to surgery and the intensity of the strengthening exercises during rehab.

Risk

As with any surgical procedure, complications can occur, some possible complications may include, but are not limited to the following:

  • Infection
  • Damage to nerves, tendons or cartilage
  • Stiffness or loss of joint motion
  • Tumor, Mass may reappear, though this is uncommon

Stiffness can be addressed post-surgery with rehabilitation

 

Procedure Cost: $4,495.00
CPT 25447