Antony Hazel, MD, hand specialist at Norton Arm & Hand Institute, specializes in unique thumb surgery
LOUISVILLE People commonly ask a friend or neighbor if they know a good handyman. After all, it is always good to know someone who knows how to fix things, such as a leaky faucet or a broken washing machine. But what sort of handyman do you call for an injured hand? If you’re anywhere within 200 miles of Louisville, the answer is likely to be Antony Hazel, MD, orthopedic hand surgeon at Norton Arm & Hand Institute in Louisville.
Hazel treats a variety of upper extremity issues, but is becoming proficient and widely known for a thumb implant procedure that can have a major impact on a patient’s quality of life.
“You can bring function back to people and help get their lives back,” Hazel says. “I don’t think there’s anything more rewarding. Our hands are everything.”
Hazel was born in Southern California and grew up in Arizona. He attended the University of Arizona and then went to the University of California, Irvine for medical school. He completed an orthopedic surgery residency at Loyola (Illinois) University Medical Center and a fellowship at UC Irvine.
He met his wife, Jenny Olges, MD, in medical school. Olges, who is from Saint Matthews, Kentucky, is director of the University of Louisville Internal Medicine Residency program. The couple moved to Louisville in 2016. In addition to Jennifer, Hazel’s father and brother are both child psychiatrists, his sister is an endocrinologist, and his sister-inlaw is in family practice.
“I’ve been around hospitals since I was around 15,” Hazel says. “Growing up in medicine, I wanted to do something different from my dad. I was always interested in the surgical fields and liked the idea of doing something with my hands.”
Ultimately, he learned that he liked helping patients use their hands effectively as well. He recalls the impact one of his mentors at UC Irvine, Neil Jones, MD, had on him in medical school. Jones, who is now retired, introduced Hazel to hand surgery and the complexities of hand function.
“The challenge drew me in,” Hazel says of being a hand surgeon. “It involves multiple different types of tissue you can operate on – skin, tendon, joints, bone, blood vessels, or nerve as well as different techniques including microsurgery, arthroscopy, and joint arthroplasty. You can be helpful anywhere on the body with a comprehensive skillset.”
The Patient Population
Hazel is in clinic two days a week with two days scheduled for surgery. The fifth day can be administrative work or additional surgeries. In clinic, he sees patients of all ages presenting with a variety of issues, such as carpal tunnel syndrome, trigger finger, Dupuytren’s contracture, De Quervain’s syndrome, or ganglion cysts. He also treats conditions such as tennis elbow, fractures, and other trauma.
What brings people from far and wide, however, is his expertise with thumb implant surgery. The Modular Thumb Implant made by BioPro replaces the damaged joint surfaces of the basal joint between the wrist and thumb.
“The patient has usually been having a problem for years,” Hazel says of the typical candidate for this procedure. “They have pain at the base of the thumb. They have difficulty pinching or gripping, where the activities of daily living are becoming hard to do. They have exhausted using a brace, they are tired of getting shots, and the shots have a diminishing relief.”
These patients tend to be in their 60s, though Hazel has performed the surgery on those as young as 38. Many are still working and need their hands to successfully do their jobs.
“It’s arthritis. Bone on bone,” Hazel says. “Sometimes the joint can even have subluxation where it’s not dislocated, but it is not sitting in the right spot. Any time they attempt to move it, it can hurt quite a bit.”
That pain becomes debilitating and the thought of relief-delivering surgery becomes more appealing.
“Patients are ready to undergo the surgery when they are tired of dealing with the pain,” Hazel says.
The Benefit of the Implant
Hazel says the procedure is an improvement over the traditional trapeziectomy, which removes the trapezium bone at the base of the thumb.
“If you’re a younger patient, no one is really excited to do that because with time, you would worry about subsidence, where the first metacarpal basically descends onto the scaphoid,” Hazel says. “If you remove the trapezium in a young person, at some point they may subside causing a new set of issues. That is a difficult problem to handle. The risk of subsidence has always made me nervous about doing a traditional trapeziectomy. The implant makes a lot of sense because it tries to restore normal anatomy.”
Being the only surgeon who does the BioPro Modular Thumb Implant procedure in an approximate 200-mile radius, Hazel has had patients come from as far as Tennessee, Missouri, Illinois, and Indiana for the procedure. He first performed it eight years ago, and to date he estimates that he has performed about 40 of these surgeries, with a significant increase in the last two years.
“The hardest part of the procedure is creating the socket because there is no template for that,” Hazel says. “We’re still trying to figure out how long the implant can last. Even if it is 10 to 15 years, I feel like that can get people through a big majority of their really active phase of life.”
Though he’s had good success with the procedure, Hazel makes sure that patients understand that is not a pleasant recovery and that nothing is guaranteed.
“You don’t want to give false hope,” he says. “It is going to hurt. For a month, you are going to be slowed up, and the recovery is a three-month process. I try to overcaution patients at the beginning so when they tell me it is not as bad as they envisioned, I feel like I have prepared them well. Patients who are further along have told me that sometimes they forget that they have had anything done. When you give people back their ‘normal’ function, that is a real homerun.
It is incredibly impactful for any patient, but perhaps more so for those working in physically demanding occupations. The procedure can prevent them from having to change careers.
“Patients are able to return to hard labor with the implant,” Hazel says. “They can get a lot of strength back, so I don’t limit them on what they can do functionally.”
Restoring functionality. That’s the work of a true “handyman.”