Pyrocardan® implant after failed trapeziectomy

The aim of this retrospective study was to analyze the medium-term results of patients treated with a pyrocarbon interposition implant (Pyrocardan®, Wright Medical™) after failed trapeziectomy. Eight female patients with an average age of 63 years were included in this single-center study. The average follow-up was 54 months (28-85 months). The average time elapsed between the trapeziectomy and the revision surgery was 116 months. Trapeziectomy failures were due to a painful scaphometacarpal and/or metacarpotrapezoid impingement. Patients were assessed radiologically and clinically for range of motion, strength (pinch and grip), pain (visual analog scale - VAS) and function (QuickDASH and PRWE scores). We found pain reduction with the mean VAS decreasing from 6.3 preoperatively to 2.5 postoperatively. Function improved with the QuickDASH and PRWE scores going from 52.9 and 49.1 preoperatively to 30.7 and 31.0 at the last follow-up, respectively. Strength and range of motion did not change significantly. Seven patients were satisfied or very satisfied with the surgery, while one patient did not experience any improvement after surgery. There was no radiological evidence of dislocation or bone reaction around the implant. Revision of failed trapeziectomy with the Pyrocardan® implant in cases of severe and painful first metacarpal subsidence is an effective solution that improves pain and function in the medium term.