A Painful, Squeaking Pyrolytic Carbon Metacarpophalangeal Joint Replacement.

Metacarpophalangeal (MCP) joint arthroplasty with pyrolytic carbon implants is a common procedure that is performed to alleviate pain from arthritis. The material properties of pyrolytic carbon are discussed with regard to their efficacy in MCP joint arthroplasty. We report a case of a painful, squeaking MCP joint arthroplasty treated with revision arthroplasty. Squeaking is a rare complication of MCP joint arthroplasty and is usually asymptomatic with spontaneous resolution. However, in this case, the squeaking was persistent and likely related to intraoperative findings of implant subsidence, debris, wear, and an incongruent joint. We also see in this case that the revision pyrolytic carbon MCP arthroplasty underwent subsidence within 2 years of revision surgery and ultimately was revised to a silicone MCP arthroplasty.