Pyrocardan® implant interposition in the trapeziometacarpal joint: outcomes at a minimum 10 years' follow-up.

Abstract

Objective: We present long-term results for the Pyrocardan®, a pyrocarbon trapeziometacarpal interposition implant used for the treatment of osteoarthritis of the thumb.

Methods: Between March 2009 and May 2013, 199 arthroplasties were performed in a single hand center, in 184 patients by 6 hand surgeons. 107 implants were followed up for a mean 137 months (range, 120 to 168 months). 82 patients (89 implants) were lost to follow-up.

Results: Median age was 57 years, with 15 patients (14.2%) aged ≤50 years. At last follow-up, functional scores were significantly improved compared to preoperative data: pain rating, 0.4/10 versus 7.2/10; Patient-Rated Wrist/Hand Evaluation, 4/100 versus 61/100; Quick Disabilities of the Arm, Shoulder and Hand, 9/100 versus 54/100. Range of motion and strength were comparable to the contralateral side. Radiographic analysis showed that 82% of implants were correctly positioned. No implant dislocation was observed. There were 6 re-operations, 5 of which in the short term. Overall implant survival was 94.3%, with 44.7% loss to follow-up.

Conclusion: Pyrocardan® interposition arthroplasty is a valid alternative for the treatment of osteoarthritis of the thumb.

Level of evidence: IV.