Pyrocarbon Implant for Trapeziometacarpal Arthritis: Mid-term Clinical and Radiological Results

Abstract

AbstractPyrolytic carbon implants for trapeziometacarpal (TMC) arthritis have been extensively studied, but there is still discrepancy in the literature concerning the mid-term functional results. Our group describes the clinical and radiological results after five years of surgical management of TMC arthritis with Pyrodisk (Integra Life Sciences, Plainsboro, NJ, US). A total of 19 patients (2 males and 17 females) aged 56.45 ± 5.95 (range: 44 to 67) years were reviewed with a mean follow-up of 74.05 ± 14.43 (range: 60.00 to 105.83) months. At the final follow-up, the score on the Visual Analogue Scale (VAS) for pain was of 1.76 ± 2.05, the average score on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire was of 22.73 ± 22.33, and all functional parameters were above the 90% barrier of the contralateral side. The progression of radiolucency was 89% at 1 year and 11% at 5 years of follow-up respectively, but it was not related to the clinical outcomes. The prevalence of subluxation (around one-fourth of the center of the implant) was of 24% in asymptomatic patients, and dislocation was not observed. The overall survival of the implant was of 89%. Revision took place in 11% of the cases due to persistent pain and implant breakage after direct impact. More than 75% of the patients were very or highly satisfied with the treatment. In conclusion, Pyrodisk enabled us to obtain good functional mid-term results, with an acceptable survival of the implant and low risk of dislocation. Radiological findings do not necessarily translate into clinical symptoms.