Related Experiment Video
Updated: Jul 4, 2026
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Pyrocarbon implants in shoulder arthroplasty: a systematic review and meta-analysis.
Juan Aguilar-Gonzalez1, Valeria Vismara2,3, Jose María Lamo-Espinosa4,5
1Department of Orthopaedic Surgery, Hospital Vithas Valencia 9 de Octubre, Valencia, Spain.
JSES Reviews, Reports, and Techniques
|July 3, 2026
Summary
Pyrocarbon (PyC) implants show high survival for stemmed humeral head arthroplasty (HA-PyC) but lower survivorship for PISA. Functional outcomes improve, but glenoid wear is a concern, necessitating careful patient selection and surgical technique.
Area of Science:
- Orthopedic surgery and biomaterials science.
- Investigating the comparative efficacy of different implant materials in shoulder arthroplasty.
Background:
- Shoulder arthroplasty utilizes chrome-cobalt, pyrocarbon (PyC), and ceramic materials for humeral head replacement.
- Increasing use of PyC implants, including PyC interposition shoulder arthroplasty (PISA) and PyC hemiarthroplasty (HA-PyC), prompts investigation into material-specific outcomes.
Purpose of the Study:
- To systematically evaluate implant survival, functional outcomes, revision rates, complications, and radiological changes associated with PyC in shoulder arthroplasty.
- To compare the performance of different PyC implant designs (HA-PyC vs. PISA).
Main Methods:
- Systematic review and meta-analysis of studies with ≥1-year follow-up.
- Searched multiple databases (MEDLINE, Embase, Cochrane, Scopus, Web of Science) without date or language restrictions.
- Assessed study quality using the Methodological Index for Non-Randomized Studies and certainty of evidence with GRADE guidelines.
Main Results:
- Pooled implant survival was 96%, with significant heterogeneity.
- Stemmed HA-PyC demonstrated higher survival (98%) compared to PISA (87%).
- Overall revision rate was 5%, with functional outcomes and range of motion improving significantly; however, glenoid wear was a notable finding across PyC types.
Conclusions:
- Stemmed HA-PyC exhibits high and encouraging survival rates.
- PyC resurfacing and PISA show inferior survivorship, highlighting the need for careful patient selection and surgical technique.
- Further high-quality comparative trials are necessary to elucidate long-term benefits and material-specific risks.
