Pyrocardan® interpositional arthroplasty for trapeziometacarpal osteoarthritis: a minimum four year follow-up

Background Pyrocardan (R) (Wright Medical-Tornier) is a pyrocarbon implant proposed in the treatment of trapeziometacarpal joint (TMCJ) osteoarthritis. Our aim was to assess the clinical and radiographic results after Pyrocardan (R) arthroplasty at midterm follow-up. Methods In this prospective monocentric study, we enrolled 119 patients treated with Pyrocardan (R) for TMCJ osteoarthritis and followed up at a minimum of four years. The clinical outcome was assessed through the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Visual Analog Score (VAS) for pain and the Kapandji score collected pre-operatively, at three, six and 12 months, then yearly. Hand radiographs were taken before surgery, at three months and every year. Complications and re-operations were also recorded. Results The mean follow-up was 5.2 years (range, 4-9). DASH, VAS and Kapandji scores significantly improved at three (p < 0.001 in all cases) and six months (p < 0.001, p = 0.01 and p < 0.001, respectively), remaining stable over time. The dislocation and subluxation rates were 3.3% (4 cases) and 16.8% (20 patients), respectively. The two year, four year and seven year survivorship of the implant was 99%, 98% and 95%, respectively. Conclusion Pyrocardan (R) arthroplasty provides a satisfactory clinical and radiographic outcome for treating TMCJ osteoarthritis, with a 97% survival rate at four years. We advocate comparative studies with more common techniques (i.e., trapeziectomy) to verify its cost-effectiveness.

Automated summary

This study aimed to evaluate the clinical and radiographic outcomes of Pyrocardan (R) arthroplasty for treating trapeziometacarpal joint osteoarthritis. The results showed significant improvements in clinical scores and X-ray findings after surgery, with stable results during the follow-up period. The incidence of complications was low, and the implant had a high survival rate.