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Pyrocarbon implants for the basal thumb arthritis.

P Bellemère1

  • 1Institut de la Main Nantes-Atlantique, Santé-Atlantique, Avenue Claude Bernard, 44800 Saint-Herblain, France.

Hand Surgery & Rehabilitation
|January 17, 2021
PubMed
Summary

Pyrocarbon implants offer a reliable alternative for basal thumb arthritis treatment, overcoming limitations of older silicone implants. These newer options provide good functional outcomes with fewer complications for patients.

Keywords:
ArthritisArthroplastieArthroplastyArthroseArticulation scapho-trapézo-trapézoïdienneArticulation trapézo-métacarpienneCarpometacarpal jointImplantInterpositionPoucePyrocarbonScaphotrapeziotrapezoid jointSiliconeThumbTrapeziometacarpal joint

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Hand surgery

Background:

  • Silicone implants, popular since the 1970s for basal thumb arthritis, had high complication rates (instability, breakage, foreign body reactions).
  • These issues led to widespread abandonment of silicone implants by many surgeons.
  • Pyrocarbon implants emerged in the 2000s as a potential alternative.

Purpose of the Study:

  • To review the surgical techniques and outcomes of pyrocarbon implants for basal thumb arthritis.
  • To evaluate pyrocarbon implants as a reliable alternative to other treatment modalities.
  • To discuss the relevance of minimally invasive surgery with pyrocarbon implants for specific patient groups.

Main Methods:

  • Review of published data on pyrocarbon implants for basal thumb arthritis.
  • Inclusion of author's personal experience with pyrocarbon implant surgery.
  • Analysis of surgical techniques, including hemiarthroplasty and interposition arthroplasty.
  • Consideration of supplemental ligamentoplasty when required for stability.

Main Results:

  • Pyrocarbon implants are available in various models for different arthroplasty types.
  • Some pyrocarbon implants require additional ligamentoplasty to prevent instability.
  • Miniaturized implants facilitate minimally invasive surgical approaches.
  • Medium- and long-term follow-up data indicate pyrocarbon interpositions are reliable.
  • These implants are suitable for low-to-medium grade osteoarthritis, particularly in young, active individuals.

Conclusions:

  • Pyrocarbon implants represent a dependable alternative for treating basal thumb arthritis.
  • They offer improved outcomes compared to historical silicone implants.
  • Minimally invasive options with pyrocarbon implants are beneficial for select patient populations.