Cuenca-Llavall M, Lizano-Díez X, Cruz-Sánchez M, Cebamanos-Celma J, Pidemunt-Moli G
Unidad de Cirugía de Mano y Codo, Traumatología Lenox Corachan, Clínica Corachan, Barcelona, España; Unidad de Extremidad Superior, Servicio de Cirugía Ortopédica y Traumatología, Hospital de l'Alt Penedès, Vilafranca del Penedès, España.
Unidad de Cirugía de la Mano, Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 Sep-Oct;62(5):373-379. doi: 10.1016/j.recot.2018.01.002. Epub 2018 Feb 21.
To evaluate midterm functional outcome after pyrolytic carbon prosthesis (PyroDisk) implantation in the treatment of rhizarthrosis of the thumb, comparing outcomes with those of ligamentous resection/suspension/reconstruction.
A cross-sectional study retrospectively comparing 2patient groups aged between 40 and 65 years with rhizarthrosis of the thumb. Thirty-two patients operated between 2009 and 2013 were distributed between group i (interposition arthroplasy with PyroDisk implant) and group ii (ligamentous resection/suspension/reconstruction arthroplasty). Data on pain, functionality (Quick-Dash questionnaire) and articular movement were collected in 2015. In addition, a radiological study was undertaken using radiographs and CT.
Thirty-two patients, 16 in each group with mean follow-up of 35 months (23-47). Pain at the end of follow-up was greater in the group with the pyrolytic carbon prosthesis (p=0.000). According to the QuickDash questionnaire, the patients in group i achieved a mean functionality of 31.14 (0-70) points compared to 15.81 (8-24) points for group ii (p=0.027). No differences were found in degree of mobility at the end of follow-up (p=0.46). The prosthesis had to be removed in 6 cases.
The pyrolytic carbon prosthesis has been presented as an alternative treatment for rhizarthrosis of the thumb. The papers pubslished to date highlight the discrepancies in midterm functional outcomes.
Pyrolitic carbon prostheses have shown inferior functional outcomes, compared with resection/suspension/reconstruction arthroplasties.
评估热解碳假体（PyroDisk）植入治疗拇指掌指关节病的中期功能结局，并与韧带切除/悬吊/重建术的结局进行比较。
一项横断面研究，回顾性比较两组年龄在40至65岁之间的拇指掌指关节病患者。2009年至2013年间接受手术的32例患者被分为I组（使用PyroDisk植入物的间置关节成形术）和II组（韧带切除/悬吊/重建关节成形术）。2015年收集了疼痛、功能（Quick-Dash问卷）和关节活动的数据。此外，还使用X线片和CT进行了影像学研究。
32例患者，每组16例，平均随访35个月（23 - 47个月）。随访结束时，热解碳假体组的疼痛更严重（p = 0.000）。根据QuickDash问卷，I组患者的平均功能评分为31.14（0 - 70）分，而II组为15.81（8 - 24）分（p = 0.027）。随访结束时，两组的活动度无差异（p = 0.46）。有6例患者不得不取出假体。
热解碳假体已被提出作为拇指掌指关节病的一种替代治疗方法。迄今为止发表的论文强调了中期功能结局的差异。
与切除/悬吊/重建关节成形术相比，热解碳假体的功能结局较差。
