Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

J Hand Surg Eur Vol. 2020 Jun;45(5):472-476. doi: 10.1177/1753193420906805. Epub 2020 Feb 27.

Abstract

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97-144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV.

Keywords: Thumb; arthritis; arthroplasty; carpometacarpal joint; implant; pyrocarbon; trapeziometacarpal joint.

Publication types

  • Review

MeSH terms

  • Arthroplasty
  • Carbon
  • Carpometacarpal Joints* / surgery
  • Follow-Up Studies
  • Humans
  • Osteoarthritis* / surgery
  • Range of Motion, Articular
  • Retrospective Studies
  • Thumb / surgery
  • Trapezium Bone* / surgery

Substances

  • pyrolytic carbon
  • Carbon