Pyrocardan Trapeziometacarpal Joint Arthroplasty-Medium-Term Outcomes

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Rheumatology

Background:

• Trapeziometacarpal osteoarthritis significantly impacts hand function.
• Current treatments include ligament reconstruction and tendon interposition (LRTI), with varying outcomes.
• Pyrocardan, a pyrocarbon interposition implant, is designed for early-to-moderate stage disease.

Purpose of the Study:

• To evaluate the postoperative outcomes of the Pyrocardan implant for trapeziometacarpal osteoarthritis.
• To compare Pyrocardan outcomes with LRTI surgery and the implant designer's reported results.
• To assess if Pyrocardan provides greater strength than LRTI.

Main Methods:

• Prospective case series of 40 Pyrocardan implants in 37 patients.
• Patients assessed preoperatively and at multiple follow-up points (3 months to long-term).
• Outcome measures included clinical scores and grip strength, compared to historical data.

Main Results:

• No major complications or revision surgeries reported.
• Significant improvement in outcome scores from preoperative to long-term follow-up (≥2 years).
• Average 2-year grip strength (30 kg) exceeded LRTI (19.6 kg) and matched designer's series (25 kg).

Conclusions:

• Pyrocardan interposition arthroplasty is a safe and effective treatment for trapeziometacarpal arthritis.
• Patient-reported outcomes are equivalent to LRTI and comparable to the original Pyrocardan series.
• Pyrocardan demonstrates superior grip and pinch strength compared to LRTI.