Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants.
OBJECTIVE
the aim of this study was to evaluate the effectiveness of interposition arthroplasty of the trapeziometacarpal (TMC) joint with pyrolitic carbon implants for the treatment of TMC osteoarthritis.


METHODS
we evaluated two groups of patients surgically treated for TMC osteoarthritis: group 1 (34 patients - 36 TMC joints) treated with PyroDisk implantation and group 2 (25 patients - 25 TMC joints) treated with the Pyrocardan implant. All these patients were clinically evaluated at follow-up using the DASH score, Mayo Wrist score and VAS pain score.


RESULTS
the mean follow-up was 42 months in group 1 and 12 months in group 2. Both groups showed good clinical outcomes in terms of pain relief, range of motion, and pinch and grasp strength. Revision surgery was needed in only one case in group 1 (2.8%) and in three cases (12%) in group 2.


CONCLUSIONS
prosthetic replacement of the TMC joint was found to be a good solution for low-demand patients. However, the PyroDisk could be a good solution in selected patients (Eaton stage I-III, non-subluxated joint): it provides good pain relief, good range of motion, good pinch and grasp strength, and stable results at more than three-years of follow-up.


METHODS
Level IV, therapeutic case series.
Division of Hand Surgery, Gaetano Pini Orthopaedic Institute, Milan, Italy.
Simona
S
Odella
Division of Hand Surgery, Gaetano Pini Orthopaedic Institute, Milan, Italy.
Amos M
AM
Querenghi
Clinical Institute Sant'Ambrogio, Milan, Italy.
Roberta
R
Sartore
Division of Hand Surgery, Gaetano Pini Orthopaedic Institute, Milan, Italy.
Agostino
A
DE Felice
Division of Hand Surgery, Gaetano Pini Orthopaedic Institute, Milan, Italy.
Ugo
U
Dacatra
implant; interposition arthroplasty; osteoarthritis; pyrocarbon; trapeziometacarpal