Arthritis Alleviated

Kimberly McKenzie is a self-starter. After graduating high school, she trained to become a cosmetologist and then opened a hair styling salon. She used that initiative and determination when arthritis pain at the base of her right thumb made work difficult.

To keep her salon running, Kimberly, 55, adapted her technique and eased her discomfort with over-the-counter pain medications. When those failed, she underwent steroid injections every three months. After 18 months, she sought a more permanent solution in surgery.

“I couldn’t pick up or turn anything,” Kimberly said. “I’d leave work crying because it hurt so much. I waited as long as possible for surgery since I’m self-employed, but I couldn’t wait any longer.”

Curtailed Cushion

Kimberly, a Gladstone resident, had osteoarthritis, a condition when joint cartilage breaks down, causing painful bone-on-bone friction. Wear and tear left her without a cushion of cartilage — where the thumb and wrist bones meet, known as the carpometacarpal (CMC) joint. The CMC joint is vital for moving one’s thumb up and down and side to side. Kimberly met the condition’s three primary causes — age, family history of arthritis and repetitive use of one’s hands.

Jeffrey Bradley, MD, a North Kansas City Hospital orthopedic surgeon with Orthopedic Health of Kansas City, performed Kimberly’s CMC arthroplasty outpatient surgery last December. As a hand surgeon specialist, he removed her trapezium bone and replaced it with a tendon graft. To keep her thumb from moving, she returned home with a plaster splint and medications for pain control. Two weeks later, her splint was replaced with a cast, which she wore for three weeks. After that, she was fitted with a removable hand splint at NKCH’s Physical Therapy & Sports Medicine.

Dedicated Work

Five weeks after her surgery, Kimberly began twice weekly hand therapy sessions with an occupational therapist, Rebecca Bertrand, MOTR/L, CHT, CLT, one of five NKCH certified hand therapists. By the end of March, Kimberly moved to once-a-week sessions.

With her thumb immobilized for several weeks, Kimberly needed to reduce her thumb’s stiffness. Rebecca initially worked with her on gentle stretching, progressing to strengthening to help overcome the weakness and loss of muscle in Kimberly’s thumb.

“Oftentimes, the thumb’s larger muscles based at the forearm try to overpower small stability muscles between the thumb and palm, which Kimberly needed to strengthen due weakness,” Rebecca said. “We worked on properly targeting and engaging those muscles, while also doing other activities like picking up pegs and turning knobs.”

For Dr. Bradley, hand therapy is paramount. “My job is to get rid of the arthritis. The most important piece is for the patient to regain range of motion and strength through hand therapy,” Dr. Bradley said. “Hand therapists put in a significant amount of time and training to gain their expertise. I know I can rely on them for my more complicated reconstructions, like these CMC arthroplasties.”

Strengthened Resolve

Kimberly continued her at-home exercises and slowly got back to work one day a week before her last hand therapy session April 13, but she had more in store. A week later she had the same surgery on her left thumb for the same condition.

“My right thumb pain after surgery was much less than the arthritis pain, so I was ready to have surgery and therapy for my left thumb pain,” Kimberly said.

Dr. Bradley attributes much of Kimberly’s recovery to her thirst for knowledge and drive. “From the start, she asked questions to prepare herself for surgery and the recovery period,” Dr. Bradley said. “After surgery, she was motivated to do the work and see things through to the finish line.”

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