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Published on: August 17, 2022
Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the
M Cuenca-Llavall1, X Lizano-Díez2, M Cruz-Sánchez3
1Unidad de Cirugía de Mano y Codo, Traumatología Lenox Corachan, Clínica Corachan, Barcelona, España; Unidad de Extremidad Superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital de l'Alt Penedès, Vilafranca del Penedès, España.
Objective:
To evaluate midterm functional outcome after pyrolytic carbon prosthesis (PyroDisk) implantation in the treatment of rhizarthrosis of the thumb, comparing outcomes with those of ligamentous resection/suspension/reconstruction.
Material And Methods:
A cross-sectional study retrospectively comparing 2patient groups aged between 40 and 65 years with rhizarthrosis of the thumb. Thirty-two patients operated between 2009 and 2013 were distributed between group i (interposition arthroplasy with PyroDisk implant) and group ii (ligamentous resection/suspension/reconstruction arthroplasty). Data on pain, functionality (Quick-Dash questionnaire) and articular movement were collected in 2015. In addition, a radiological study was undertaken using radiographs and CT.
Results:
Thirty-two patients, 16 in each group with mean follow-up of 35 months (23-47). Pain at the end of follow-up was greater in the group with the pyrolytic carbon prosthesis (p=0.000). According to the QuickDash questionnaire, the patients in group i achieved a mean functionality of 31.14 (0-70) points compared to 15.81 (8-24) points for group ii (p=0.027). No differences were found in degree of mobility at the end of follow-up (p=0.46). The prosthesis had to be removed in 6 cases.
Discussion:
The pyrolytic carbon prosthesis has been presented as an alternative treatment for rhizarthrosis of the thumb. The papers pubslished to date highlight the discrepancies in midterm functional outcomes.
Conclusions:
Pyrolitic carbon prostheses have shown inferior functional outcomes, compared with resection/suspension/reconstruction arthroplasties.
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