Capitate Pyrocarbon Prosthesis in Radiocarpal Osteoarthritis

Abstract

Scapholunate dissociation or scaphoid pseudarthrosis may lead to osteoarthritis of the wrist. When osteoarthritis affects the midcarpal joint, proximal row carpectomy is no longer possible and only 4 corners fusion or capitolunate arthrodesis may be indicated. However, in some cases, osteoarthritis or bone necrosis may involve the lunatum, making partial arthrodeses impossible. Total arthrodesis may be proposed in such cases, but with a loss of range-of-motion. Total prosthesis may be considered but the results of this procedure are not always encouraging. Consequently, in these situations, we perform pyrocarbon prosthesis implant, replacing the head of the capitatum. This article describes the procedure and the results of a preliminary study.

Novel approach for posttraumatic panarthritis of the wrist using a pyrocarbon interposition arthroplasty (Amandys®): Preliminary series of 11 patients

“…Goubier et al [15] published a series of seven patients having received a capitate bone implant (RCPI 1 ) at the mean follow-up of 30 months. This pyrocarbon implant differs from the Amandys 1 by its implantation stem for insertion into the capitate bone.…”

“…Jackson [12] proposed a silastic sheet spacer and Kwon et al, a capsular spacer [13]. More recently, Gontran [14] and Goubier et al [15] proposed resurfacing the head of the capitate bone with a pyrocarbon implant named RCPI 1 (Tornier 1 ) (resurfacing capitate pyrocarbon implant) which has a stem for positioning within the capitate bone. Their results appear encouraging.…”

Amandys® implant: Novel pyrocarbon arthroplasty for the wrist

“…The Roux partial wrist prosthesis replaces the radial epiphysis completely and is indicated in comminuted fractures and tumors of the radius [22]. Goubier reports results of a pyrocarbon implant RCPI 1 (Tornier SAS-Bioprofile Grenoble, France), which replaces the head of the capitate after resection of the first carpal row [21]. In a series of seven cases with mean follow-up of 30 months, the mean postoperative range of flexion-extension of 558 (loss of 148 of preoperative value) was inferior to that in our series.…”

“…New models of the prosthesis have recently been developed but still lack followup [18,19]. The same goes for limited series of partial arthroplasties [20][21][22].…”

Carpectomía proximal. Estudio por elementos finitos

“…A pesar de ello, y tal como hemos apuntado antes, es preciso realizar nuevos estudios, diferenciando especialmente los tres tipos de configuración de la cabeza del hueso grande, pues muy bien podrían observarse las alteraciones del comportamiento biomecánico para cada uno u otro tipo morfológico. Sea como fuere, algunos autores, después de practicar una CP, interponen tejido capsular entre el radio y la cabeza del hueso grande 21 o incluyen un implante de carbón pirolítico en la cabeza del hueso grande para evitar la artrosis entre el mismo y el radio 22 . Aunque los resultados iniciales con este implante son satisfactorios, es preciso un seguimiento a más largo plazo y contar con series más homogéneas y extensas para sacar conclusiones al respecto.…”