title: Novel approach for posttraumatic panarthritis of the wrist using a pyrocarbon interposition arthroplasty (Amandys(®)): Preliminary series of 11 patients.
abstract: OBJECTIVE
  In case of posttraumatic radiocarpal destruction, failure of first row carpectomy or partial arthrodesis, there are two options, total prosthesis of the wrist or panarthrodesis. Both solutions have limitations. The aim of our study was to evaluate an alternative therapy: interposition arthroplasty with pyrocarbon implant at follow-up of minimum 6months.
  
  
  METHODS
  This is a retrospective monocentric study with clinical and radiological evaluation. This study includes 11 patients with a mean age of 55.2years. There were four failures of first row carpectomy, a failure of partial arthrodesis, a case of post-infection osteoarthritis, four cases of stage IV SNAC wrists and one siliconitis after a scaphoid implant.
  
  
  RESULTS
  At the average follow-up of 11 months, pain was improved in nine cases. The average flexion was 36.5° and average extension, 35°. The average strength was 8.3kg. Two implant dislocations occurred, only one required second look surgery for implant replacement. However, in this patient, pain remained severe and required panarthrodesis. In another patient, a second panarthrodesis was performed for resistant pain.
  
  
  CONCLUSIONS
  The interposition arthroplasty with pyrocarbon seems to give encouraging results as an alternative therapy. It gives satisfactory mobility, pain relief, but moderate strength. It has the advantages of a simple technique and does not preclude manual activities. A long-term validation is, of course, necessary.
authors.affiliation: Unité de chirurgie de la main et des nerfs périphériques, hôpital Européens Georges-Pompidou (HEGP), université Paris-Descartes, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris (AP-HP), Paris cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Pierrart
authors.forename: P
authors.initials: P
authors.lastname: Bourgade
authors.forename: W
authors.initials: W
authors.lastname: Mamane
authors.forename: T
authors.initials: T
authors.lastname: Rousselon
authors.forename: E H
authors.initials: EH
authors.lastname: Masmejean
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000209:etiology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000295:instrumentation* / Q000379:methods; D001672:Biocompatible Materials; D002244:Carbon; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000150:complications*; D014955:Wrist Joint / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials; C009139:pyrolytic carbon; D002244:Carbon