Thumb carpometacarpal osteoarthritis: trapeziectomy versus pyrocarbon interposition implant (Pi2) arthroplasty.
We retrospectively compared the short-term outcomes of 18 thumbs that had a trapeziectomy and 18 that had a pyrocarbon interposition implant (Pi2) arthroplasty in 33 patients. We measured the Disability of the Arm, Shoulder, and Hand (DASH) and Short Form 36 (SF-36) scores at a mean of 20 months. Pain severity was assessed using a visual analogue scale (VAS), and level of patient satisfaction was assessed using a 5-point scale. The mean DASH scores at follow up were 27 for those that had a trapeziectomy and 35 for those that had a Pi2 arthroplasty (p = 0.001). There was no difference in the VAS for pain, SF-36 scores, or other parameters assessed. Six out of 18 (33%) thumbs in the Pi2 group had multiple operations, usually for dislocation or subluxation of the implant. The early results of Pi2 arthroplasty show a high complication rate compared with trapeziectomy and no identifiable benefit.
Department of Orthopaedics and Trauma, Sunderland Royal Hospital, Sunderland, UK. mmaru@doctors.org.uk
M
M
Maru
P
P
Jettoo
L
L
Tourret
M
M
Jones
L
L
Irwin
D000368:Aged; D000704:Analysis of Variance; D019643:Arthroplasty, Replacement / Q000379:methods*; D002244:Carbon; D052737:Carpometacarpal Joints / Q000601:surgery*; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013933:Thumb / Q000601:surgery; D051222:Trapezium Bone / Q000601:surgery*
D002244:Carbon