Two Thumbs Up for Arthritis Surgery

One December evening in 2016, retired music teacher Janis Jones was preparing her famous jambalaya for a dinner party. It was a fun gathering just before she left for a winter vacation, and she spent much of the day happily chopping vegetables. The evening went off without a hitch.

“But the whole time I was away, I had pain in my left thumb,” Janis recalls. “When I returned home, I went straight to my doctor. When she recommended that I go to an orthopedist, I knew exactly who to see. My friend had hand surgery by Dr. Alison Kitay and loved her.”

Specialized Expertise

Dr. Kitay is chief of hand surgery at MedStar Montgomery Medical Center and assistant professor for orthopaedics at MedStar Georgetown University Hospital. A Harvard-fellowship-trained orthopaedic hand surgeon, Dr. Kitay has the kind of specialized expertise that Janis needed.

“Ms. Jones’s X-rays showed that she had arthritis in her left thumb,” explains Dr. Kitay. “Since she is left-handed, the pain was disrupting every aspect of her life.”

Our opposable thumbs have a remarkable range of motion that allows us to pick up a glass, throw a ball, and—most critically for Janis—play piano.

“Arthritis in the thumb is a common condition, and patients experience pain with many activities of daily living, such as pinching a key, or pulling the lid off of a yogurt container. When cartilage is worn away, bone-on-bone pain can be very debilitating,” Dr. Kitay says. “Often people aren’t aware they have treatment options.”

“We always begin with the least invasive therapy. For Ms. Jones and most patients, that means bracing and cortisone injections to reduce inflammation.” These work very well, but pain relief is often temporary. That was true for Janis. “The shots and braces helped,” says Janis. “But the pain returned, and in September, I decided to have surgery.”

Same-Day Surgery, Long-Term Relief

“I was a little nervous the day of surgery,” Janis confesses. “I remember the anesthesiologist telling me I was going to have a nerve block to numb my arm, and that she would give me something to sleep. The next thing I remember thinking was ‘I wish they would just do this.’ That’s when they told me they had!”

Alison Kitay, MD

During the procedure, Dr. Kitay made a small incision of less than 4 cm at the base of the thumb to remove the arthritic joint.

“Then I performed a tendon transfer to stabilize the area. The surgery took less than an hour, and Ms. Jones was discharged the same day.” Ten days after surgery, Dr. Kitay removed the stitches and a certified hand therapist outfitted Janis with a removable splint. Weeks later, Janis started outpatient therapy to regain motion and strength. Janis experienced a speedy recovery. By Christmas, she was playing carols.

“In December I was good. By January I was very good!” she says. Dr. Kitay isn’t surprised. “These are some of my happiest patients. Most say they achieve 98 to 99 percent pain relief when therapy ends. While I tell patients it may take a year for complete recovery in terms of strength, most are pain-free in weeks. This is a great procedure to give patients back a pain-free functional thumb,” she adds.