Ensemble PyrocarbonTM Hemiarthroplasty for the Treatment of Painful Thumb Carpometacarpal Joint Arthritis with Sparing of the Trapezium

Abstract

Due to its remarkable mechanical properties and excellent biocompatibility, PyrocarbonTM is an ideal material for articular use. Various Pyrocarbon implants for the hand and wrist have been developed over the past 25 years. The Ensemble implant is unique in that it can be inserted as a minimally invasive hemiarthroplasty technique that does not require any preparation to insert a stem into the thumb metacarpal. The device has a unique three-dimensional design that locks onto the surface of the trapezium without requiring any internal fixation. We report on our first 12 cases with 1 year follow-up. There was significant improvement in the DASH score and pinch strength at 1 year follow-up (p< 0.5) with no significant decrease in thumb motion or instances of dislocation. One patient was revised due to rapid progression arthritis at the scaphoid trapezial interface that required revision to an arthroplasty with complete removal of the trapezium.