Prior to receiving life-changing CMC joint-replacement surgery, Sandra had the “thumbs of a 70-year-old in her early 50s”

Sandra's crippling osteoarthritis symptoms led her to have CMC joint replacement surgery

Sandra's pain from her osteoarthritis had become so unbearable and disruptive to her life that in January 2020 she decided to see Mr Andy Hacker, Consultant hand and wrist surgeon at the Saxon Clinic in Milton Keynes for life-changing surgery. She underwent CMC thumb joint replacement surgery for her left-hand and just months later in October 2020, Sandra underwent surgery for her right-hand also.

We explain what CMC thumb joint replacement surgery involves, including what you could expect after surgery and how Sandra herself has benefitted from this procedure. We also investigate the potential causes of osteoarthritis and the devastating impact it can have on your mental health and day-to-day life. 

What is osteoarthritis?

The NHS reveals osteoarthritis is the most common form of arthritis in the UK. Osteoarthritis is a musculoskeletal condition that leads to stiffness and pain in your joints. Your mobility can be affected and you might also experience swelling and tenderness in your joints. Our Joint Pain Matters survey reveal 37.12% of people with joint pain suffer from osteoarthritis. More than a third (34.89%) of people with osteoarthritis report experiencing pain in their hands and wrists.

Osteoarthritis causes: Sandra’s osteoarthritis is hereditary

For Sandra, osteoarthritis runs in her family. Her brother and sister both suffer from pain in their hands. Sandra began experiencing pain in her early 30s, while she was working as a research scientist. But after having children in her mid-30s, she noticed her pain had improved while she was pregnant. An article published by the BMJ supports this and reveals pregnancy-related hormones can have an anti-inflammatory affect. These hormones produced during pregnancy can also have a positive influence on inflammatory types of arthritis such as rheumatoid arthritis.

Consultant Hand and Wrist Surgeon Mr Andy Hacker explains: "Arthritis of the thumb joint commonly affects people around the age of 50 to 80 years old. In my practice I see more women that are affected by this than men. They often present with pain and a grinding sensation of the thumb. They also often present with deformities of the thumb, decreased grip strength and an inability do everyday activities."

However, Sandra's pain soon returned and rapidly became worse. As she reached her early forties, the pain in her hand had become daily and constant.

"It affected everything I did," she tells us. "Even doing normal things, for example pairing socks, using tweezers or doing my buttons up was unbearable and uncomfortable. Even clapping hurt. At Christmas I had to buy a stamp to sign my cards because the pain was so much, I couldn't write them. It made me feel miserable because I was using my hands all the time."

Sandra’s osteoarthritis symptoms affected her work

Sandra's osteoarthritis meant she would experience constant aches in her hands and wrists. But if she used her hands, these general aches would turn into sharp pains.

She says: "There was no way I could go back to working as a research scientist at the laboratory. I did some volunteering for a brief period but I had to give that up as it became too uncomfortable to work."

The findings from our Joint Pain Matters survey show 43.79% of people have missed work because of joint pain. An overwhelming 68.88% of respondents admit joint pain has affected their mental health. Overall, 73.36% of women report that joint pain has impacted their mental health.

Alongside affecting her work, Sandra's pain also wreaked havoc on her sleep. Her pain would make it difficult for her to find a comfortable position in bed. She admits her pain has led to many "sleepless nights".

Sandra's osteoarthritis pain relief

Prior to having surgery for her hands, for several years, Sandra had tried alternative treatments to lessen her pain. These treatments included hand therapy activities, which used wax treatments or wax therapy.

"There are a wide of range of treatments available for patients presenting with osteoarthritis at the thumb base," explains Mr Hacker. "In my practice we start off with non-invasive techniques such as steroid injection, splinting under the care of a hand therapist, and alteration of their everyday activities." 

Although Sandra found the wax therapy 'soothing' it was a temporary and short-term comfort. She was referred by the NHS to Consultant hand and wrist surgeon, Mr Andy Hacker, who recommended that Sandra used hand braces to reduce the strain and pressure on her joints. This did provide some effective relief for a number of years but her joints continued to deteriorate.

Osteoarthritis treatments: Sandra’s choice to have CMC joint replacement surgery

Despite the debilitating impact of her hand pain, Sandra continued to put up with it to avoid having surgery. But in January 2020 she decided she couldn't tolerate the pain any further. She decided to see Mr Hacker again, by which time her joints had deteriorated so much they were similar to that of a 70-year-old. Mr Hacker recommended a new surgical procedure, CMC joint replacement surgery, which would help relieve her pain and allow her to retain a functional level of movement.

"I was at a stage where I couldn't deal with the pain anymore," she recalls. "I decided to have surgery for my left-hand first, as I am right-handed. At the time the pain was the same in both of my hands."

What is CMC joint replacement surgery?

Thumb CMC joint replacement surgery involves the removal of the arthritic joint at the base of your thumb. This arthritic joint is replaced with an artificial joint. However, to be considered for a CMC joint replacement surgery, your trapezium bone must be large enough to accommodate a replacement. The joint next to your affected joint should also not be arthritic and must be in good condition.

Prior to surgery, an X-ray of the base of your thumb and surrounding joints is carried out by your Consultant. The X-ray allows for careful pre-operative planning and assesses the severity of your arthritis. After a CMC joint replacement surgery, it can take up to three months to be able to return to doing most of your everyday activities.

Opening up about her post-surgery experience, Sandra says: "There was some discomfort and stiffness. But now if I press my fingers together, it does not hurt at all. It was extremely painful before."

Mr Andy Hacker performed Sandra's second CMC joint replacement surgery for her right-hand later that year in October 2020.

Sandra’s road to recovery from osteoarthritis in her fingers and hands

The efficacy of the CMC thumb joint replacement meant that Sandra could have both thumb joints replaced within 12 months of each other. Following her surgery, Sandra experienced some slight swelling in her thumb and tenderness over her scars. But she feels this tenderness is from her scar tissue healing. She was amazed that the second procedure was so easy and the fast recovery of her first joint replacement meant she can have both done so close together.

Mr Andy Hacker explains: "After a CMC thumb joint replacement surgery, we would hope that your range of movement and pain would be greatly improved. Sometimes, the range of movement does not improve but the patient's perception of what they're able to do with their thumb is much better as their pain is greatly improved. In the vast majority of the patients I have treated with this procedure I have seen excellent improvement in range of movement and pain scores."

Post-surgery, Sandra was seen by a hand therapist at The Saxon Clinic. She was provided with hand exercises to do which included using medical putty to exercise and manipulate the muscles in her hand. A hand brace was also made for Sandra, that she wore for the first four to six weeks after surgery.

Sandra says: "Both my scars are very neat and not bumpy. I can do everything that I would normally do. I can even use scissors for my sewing which was something I couldn't use before." Since her surgery, Sandra has noticed she no longer wakes up from her sleep because of the pain in her hands. She reveals: "I no longer have any pain in my thumbs or need splints to do my gardening. I am also now able to do my yoga classes and I couldn't be happier with the result."

She continues: "It was a whirlwind experience. I am pleased that the surgery has worked and I have recommended this surgery to my brother. I would also recommend it to anyone with the same condition. My father suffered terribly with his hands towards the end of his life as he had a very manual job. I wish this procedure had been an option for him."

Meet Mr Andy Hacker

Mr Andy Hacker is a consultant hand and wrist surgeon at Milton Keynes University Hospital and The Saxon Clinic in Milton Keynes. After qualifying from the University of Newcastle upon Tyne, Mr Hacker went on to successfully complete his postgraduate surgical training in London. During the specialist training that he received, he developed an interest in hand and wrist surgery.

Mr Andy Hacker accumulated significant surgical experience through working at a number of hospitals in and around South West London, working alongside orthopaedic and plastic hand surgeons.

A hand and microsurgery fellowship at the Royal Northshore Hospital in Sydney allowed Mr Hacker to work under the supervision of a globally renowned hand surgeon, Professor Michael Tonkin.

In 2010, he was awarded his Fellowship of the Royal College of Surgeons qualification. The following year, he joined the Milton Keynes Hospital Foundation Trust, establishing a dedicated hand and wrist surgery service.

Joint Pain Matters

If you would to seek treatment for your joint pain, we have a number of specialists at Circle Health Group who could help you. To speak to a consultant, please call us or make an online enquiry. 

To find out more about Mr Hacker or to book an appointment please click here.

Download our Joint Pain Matters report to discover more about joint pain.