Department of Public Health, Division of Orthopaedic Surgery, Federico II" University, Via S. Pansini 5, bd. 12, 80131, Naples, Italy.
Int Orthop. 2022 Aug;46(8):1803-1810. doi: 10.1007/s00264-022-05457-3. Epub 2022 Jun 8.
Pyrocardan® (Wright Medical-Tornier) is a pyrocarbon implant proposed in the treatment of trapeziometacarpal joint (TMCJ) osteoarthritis. Our aim was to assess the clinical and radiographic results after Pyrocardan® arthroplasty at midterm follow-up.
In this prospective monocentric study, we enrolled 119 patients treated with Pyrocardan® for TMCJ osteoarthritis and followed up at a minimum of four years. The clinical outcome was assessed through the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Visual Analog Score (VAS) for pain and the Kapandji score collected pre-operatively, at three, six and 12 months, then yearly. Hand radiographs were taken before surgery, at three months and every year. Complications and re-operations were also recorded.
The mean follow-up was 5.2 years (range, 4-9). DASH, VAS and Kapandji scores significantly improved at three (p < 0.001 in all cases) and six months (p < 0.001, p = 0.01 and p < 0.001, respectively), remaining stable over time. The dislocation and subluxation rates were 3.3% (4 cases) and 16.8% (20 patients), respectively. The two year, four year and seven year survivorship of the implant was 99%, 98% and 95%, respectively.
Pyrocardan® arthroplasty provides a satisfactory clinical and radiographic outcome for treating TMCJ osteoarthritis, with a 97% survival rate at four years. We advocate comparative studies with more common techniques (i.e., trapeziectomy) to verify its cost-effectiveness.
Pyrocardan®（ Wright Medical-Tornier）是一种 proposed 用于治疗腕掌关节（TMCJ）骨关节炎的热解碳植入物。我们的目的是评估 Pyrocardan®关节成形术的中期随访结果。
在这项前瞻性单中心研究中，我们招募了 119 名患有 TMCJ 骨关节炎并接受 Pyrocardan®治疗的患者，并进行了至少四年的随访。通过残疾上肢、肩部和手（DASH）问卷、疼痛视觉模拟评分（VAS）和术前、术后 3 个月、6 个月和 12 个月以及每年收集的 Kapandji 评分来评估临床结果。在手术前、术后 3 个月和每年拍摄手部 X 线片。还记录了并发症和再次手术。
平均随访时间为 5.2 年（范围为 4-9 年）。在所有病例中，DASH、VAS 和 Kapandji 评分在术后 3 个月（p<0.001）和 6 个月（p<0.001、p=0.01 和 p<0.001）时显著改善，并且随时间保持稳定。脱位和半脱位的发生率分别为 3.3%（4 例）和 16.8%（20 例）。植入物的两年、四年和七年存活率分别为 99%、98%和 95%。
Pyrocardan®关节成形术为治疗 TMCJ 骨关节炎提供了满意的临床和影像学结果，四年存活率为 97%。我们主张进行与更常见技术（即腕骨切除术）的比较研究，以验证其成本效益。
