The use of pyrocarbon as a bearing surface in shoulder arthroplasty: A systematic review and meta-analysis

Pyrocarbon has been trialed as an alternative bearing surface to metal for young active patients with glenohumeral joint arthritis. The aim of this study was to systematically review and summarize the available evidence on reported outcomes of pyrocarbon implants in shoulder arthroplasty.

A systematic review was conducted according and reported according to standardized guidelines. Patient demographics, complications, implant survivorship and patient-reported outcome measures were extracted and included in the quantitative analysis. Outcome data was summarized with weighted mean differences and proportions.

Fifteen studies were included with 904 patients and a median follow-up of 38 months. The pooled mean range of motion improvement was 43.9 degrees (95% confidence interval [95% CI] 36.7-51.2) in forward elevation and 24.1 degrees (95% CI 18.4-29.9) in external rotation. Pooled mean Constant Score improvement was 34.7 (95% CI 29.4-40.1) and Subjective Shoulder Value improvement was 40.6 (95% CI 33.4-47.8). The overall pooled re-operation rate was 8.03% (95% CI 5%-12.7%).

Pyrocarbon shoulder implants demonstrated improvements in functional outcomes with low revision rates at early- to mid-term follow-up. Further well-designed prospective studies with long-term follow-up are required to verify the safety and efficacy of pyrocarbon implants in shoulder arthroplasty.