Pyrocarbon metacarpophalangeal joint replacement in primary osteoarthritis

Abstract

The purpose of this retrospective cohort study was to evaluate the outcomes of 18 primary pyrocarbon metacarpophalangeal joint replacements in 10 patients, performed for primary osteoarthritis. The mean age at operation was 66 years and mean follow-up was 58.6 months. The arc of motion improved from a mean of 30° to 40° and the mean QuickDASH score improved from 35 to 17. All except one patient were satisfied with their outcomes. Radiographically, there has been no evidence of dislocation or overt loosening, although there has been subsidence of some components up to 5 mm. One index finger implant was revised to a silastic implant for perceived alteration of precision pinch. Other complications included one intra-operative fracture that united and an asymptomatic stem fracture of one proximal phalangeal component. We continue to use the implant and aim to review our experience in a further 5 years.

Giant Cell Tumor of the Metacarpal: Case Report

“…When collateral ligament reconstruction is possible, either to an allograft or to native bone, unconstrained prosthesis including the pyrocarbon arthroplasty or surface replacement arthroplasty (SRA) is a viable option. 7,10,16,18,[20][21][22][23][24][25] This is an important consideration in younger patients given the high rate of fracture with silicone implants. 6,20 In our report, the patient initially had a satisfactory result after reconstruction with a fresh-frozen osteoarticular metacarpal head allograft.…”

A biomechanical study of the effects of simulated ulnar deviation on silicone finger joint implant failure

“…More recently, hard-bearing implants have been developed and used with good results in osteoarthritis ( Simpson-White et al, 2014), but are often too unstable in joints destroyed by inflammatory arthritis. There is still a need for soft (silicone) implants.…”

Advances in Small Joint Arthroplasty of the Hand

“…In fact, Reissner et al found that range of motion decreased from 36° pre-operatively to 29° at 10-year follow-up for pyrocarbon arthroplasty of the PIP joint (50). Conversely, Simpson-White et al found a 10° improvement in range of motion (30° pre-operatively to 40° post-operatively) at a mean follow-up of 58.6 months after arthroplasty of the MCP joint (51). Studies on pyrocarbon implant arthroplasty have also shown statistical improvements in grip and pinch strength (42, 47) as well as occupational performance (52).…”