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Innovative thumb-joint replacement surgery puts patients on path to recovery within weeks

“A complete success… I’m in awe of Mr van der Stok and his team at Croom,” says Co Limerick patient

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Mr Johan van der Stok (centre) with John McGuire, Co Clare, and Catherine Doherty, Co Limerick, who each underwent the innovative thumb-joint replacement surgery in both hands. Their lives have been transformed by the procedure.

Friday, 22nd November, 2024 ¦ INNOVATIVE hand surgery introduced at Croom Orthopaedic Hospital last year is giving a new lease on life for dozens of patients who had all but abandoned hope of living a life free of debilitating hand pain.

This type of thumb-joint replacement surgery is a first for Ireland, and was introduced in Croom Orthopaedic Hospital by orthopaedic surgeon Mr Johan van der Stok.

The procedure, pioneered in France and used across Europe and the UK, involves replacement of the affected joint with a ball-and-socket implant, a mini version of the implants used for hip replacement for many years.

Almost 40 patients have gone through the procedure in the past year. For those who, prior to introduction of the procedure at Croom, were consigned to either painful trapeziectomy surgery, or years of pain management, injections, splints and other therapies, the surgery has placed them on the path to recovery within weeks.

Typical of Mr van der Stok’s patients are Catherine Doherty from Adare, County Limerick, and John McGuire from West County Clare. Both had been suffering hand pain for years, and all but given up on ever finding a solution before Mr van der Stok brought the procedure to the Mid West. Catherine and John successfully underwent the surgery for both thumbs in 2023. The problem typically afflicts both hands, and a third of Mr van der Stok’s patients have opted to have the second thumb treated. Due to the relatively short recovery time, the second procedure can be performed three months after the first.

Catherine Doherty: “I’d previously had carpel tunnel surgery for my wrist, and within about two years I was getting pain in my thumbs that got worse and worse, to the point where I could hardly hold my hairdryer, or peel potatoes or sweep the floor, or things like using the gearstick in the car. Eventually I went to the GP and said, I just can’t go on this this. So she sent me to Mr van der Stok and my life has just turned around. I had the first surgery done in August 2023, and the second one three months later. It was very simple, and not painful, and I would say I was well on the road to recovery within weeks, and after that, it’s just exercising it and being careful with it. I call them my ‘false thumbs’, and show them to everybody. The surgery itself is so neat, with hardly any scar, and the aftercare you get from Mr van der Stok is absolutely brilliant, with a full year of appointments where they check on you, give you exercises, and chart your strength and progress. I hadn’t heard of this type of surgery before, and honestly, I’m in awe of what Mr van der Stok and his team are doing.”

John McGuire from West County Clare had been suffering hand pain for years, and all but given up on ever finding a solution before Mr van der Stok brought the procedure to the Mid West. John underwent the surgery for both thumbs, as the problem typically afflicts both hands. A third of Mr van der Stok’s patients have opted to have the second thumb treated. Due to the relatively short recovery time, the second procedure can be performed three months after the first.

John McGuire: “I’ve always been active, and have been around horses all my life, but last year, my thumbs were so bad that I couldn’t open a milk carton or a mineral bottle. I’d had pain injections before, and they were not having any effect. I got to see Mr van der Stok, and he did my left thumb last September, and my right one three months later. It’s been a complete success. I can remember the morning my wife Anne was driving me to Croom to get the surgery, and as we were passing Bunratty the pain was so bad I was holding my hand between my knees, and I remember saying to her, ‘I honestly don’t care if he cuts it off today, but he has to do something.’ Mr van der Stok’s an amazing man, I couldn’t speak highly enough of him, and I’d recommend this surgery to anyone. Of course, I’m getting older and I’m not as strong as I was, but the strength in my hands has improved about 300 per cent from what it was before the surgery. You have to be careful with it afterwards and wear a sling for 72 hours. I did what I was told, and actually wore it for five days; I wasn’t taking any chances! I was recently with my GP who hadn’t seen me for a little while, and he couldn’t believe the transformation, and he took note of the procedure and said he could think of more people who could benefit from it.”

Mr van der Stok explained: “If the thumb joint is the cause of pain in the hand, the patient is in a very tight corner. Pain injections or splints will assist, but mostly only temporarily. The ordinary tasks of everyday life become very sore. The difficulty is that you always use the thumb; no other finger can compensate. This is a day procedure, with the patient going home in a soft dressing, and perhaps some painkillers will be needed for first two or three days. You’ll be able to use the hand for light activity almost immediately for the first six weeks, and after that you’re free to build up the strength. By contrast, the trapeziectomy, which is a different procedure for the same problem, is more invasive, with a recovery time of three months, and very few patients would be keen to repeat that process for 12 months if the other hand needs treatment.”

Having completed orthopaedic specialist training in the Netherlands in 2020, Mr van der Stok specialised in hand surgery and knee arthroplasty through fellowship training in Ireland, and is a European Board-certified Hand Surgeon. At the vanguard of thumb-joint replacement surgery in Ireland, Mr van der Stok has been involved in the training of his peers nationally, and he predicts that within the next 5-10 years the procedure will be available everywhere.

“I am delighted to work in Croom, where I am surrounded by an amazing team of staff. The entire team that have helped to make this new treatment available for our patients here in the Mid West region, and I am very proud of that.”