Long-Term Follow-Up After Pyrocarbon Disc Interposition for Thumb CMC Osteoarthritis

Cecile Cmca Van Laarhoven,Janna S.E Ottenhoff,Mark Van Heijl,Bastiaan Van Hoorn,Brigitte Van Der Heijden,Arnold H Schuurman

doi:10.1016/j.jhsa.2018.06.086

Cecile Cmca Van Laarhoven, Janna S.E Ottenhoff + Show 4 more

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https://doi.org/10.1016/j.jhsa.2018.06.086

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There is no financial information to disclose. The pyrocarbon disc has been designed for the surgical treatment of CMC thumb joint osteoarthritis Eaton and Littler 2 to 3. It is hypothesized that interposition of the implant will preserve height, stability, strength, and movement after surgery as much as possible. Our study evaluated the long-term results after pyrocarbondisc implant as interposition hemiarthroplasty for CMC thumb joint osteoarthritis for Eaton and Littler grade 2 or 3 osteoarthritis. Between 2006 and 2014, 237 thumbs were operated in our centers. After medical ethical committee approval, all eligible patients were approached to participate in the study. As primary outcome, patient reported outcome measurements were obtained, such as pain, function, satisfaction and quality of life, measured with the 5 questionnaires (PRWHE, MHQ, DASH, SF-36 and questions to measure satisfaction). As secondary outcome, power, range of motion, and position of the disc in the thumb were evaluated. These data were obtained by hand measurements and radiology evaluation. A total of 190 thumbs in 158 patients were included in the study. The preliminary results showed an average follow-up of 7 years (range 2–11 years). The mean age at operation was 59.3 years. Of the 190 placed pyrodiscs, 16 (8.4%) were removed because of ongoing problems after operation. Of the 174 thumbs in 142 patients, the preliminary results showed a median DASH of 18 and a median PRWHE of 14.5. The MHQ had a total score of 74. Satisfaction with the operation and results scored 9.0 (on a Likert scale of 1–10). The median JAMAR was 21.9 (100% of the contralateral grip power), the key pinch was 4.8, the tip pinch was 3.2, and the 3-point pinch was 4.0 (98%, 98%, and 97% of the contralateral hand, respectively). Range of motion with Kapandji was 9.0. This is the first study with long-term follow-up after pyrocarbon disc interposition for the treatment of CMC1 osteoarthritis grade 2 to 3 in more than 150 thumbs. The preliminary results show:•a high level of patient satisfaction•preservation of movement and strength•no loss of height of the first metacarpal•no luxation of the implants during the follow-up period of an average of 7 years

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