title: Pyrocarbon versus silicone proximal interphalangeal joint arthroplasty: a systematic review.
abstract: BACKGROUND
  Arthritis at the proximal interphalangeal joint can be a disabling chronic condition. Silicone arthroplasty is a common surgical treatment option to provide pain relief and maintain joint mobility. Pyrocarbon implants are gaining popularity as an alternative to silicone prostheses. The purpose of this systematic review is to compare the outcomes of silicone and pyrocarbon arthroplasties for patients with proximal interphalangeal joint arthritis.
  
  
  METHODS
  A computerized search was conducted to identify studies evaluating outcomes of silicone and pyrocarbon arthroplasties. The data extracted were patient demographics, pain relief, range of motion, grip and pinch strength, costs, quality of life, and complications.
  
  
  RESULTS
  Thirty-five relevant citations were identified. Available data showed that both arthroplasties offered satisfactory pain relief. The implants also provided similar postoperative weighted mean arcs of motion, with a value of 37.4 ± 13.6 degrees for silicone and 44.8 ± 16.8 degrees for pyrocarbon. There were comparable results in grip and pinch strengths as well. No studies were identified that performed an economic analysis of arthroplasty. Six studies assessed quality-of-life outcomes after pyrocarbon surgery, and results were mixed. The rates of revision and salvage procedures performed secondary to complications were higher after pyrocarbon arthroplasty.
  
  
  CONCLUSIONS
  Based on the available low level of evidence, pyrocarbon arthroplasty does not demonstrate clear superiority over silicone implants. In fact, there is concern about the complication rates of these implants. Future studies should focus on more rigorous study designs using validated quality-of-life scales and economic evaluations before widespread adoption of this new implant.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Hamilton, Ontario, Canada From the Divisions of Orthopedic Surgery and Plastic and Reconstructive Surgery, Department of Surgery; the Surgical Outcomes Research Center; and the Department of Clinical Epidemiology and Biostatistics, McMaster University.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chan
authors.forename: Olubimpe
authors.initials: O
authors.lastname: Ayeni
authors.forename: Leslie
authors.initials: L
authors.lastname: McKnight
authors.forename: Teegan A
authors.initials: TA
authors.lastname: Ignacy
authors.forename: Forough
authors.initials: F
authors.lastname: Farrokhyar
authors.forename: Achilleas
authors.initials: A
authors.lastname: Thoma
mesh_terms: D001168:Arthritis / Q000601:surgery*; D050806:Arthroplasty, Replacement, Finger / Q000295:instrumentation*; D001672:Biocompatible Materials; D002244:Carbon; D005384:Finger Joint; D006801:Humans; D007595:Joint Prosthesis; D012828:Silicones; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D012828:Silicones; C009139:pyrolytic carbon; D002244:Carbon