gms | German Medical Science

Objectives/Interrogation: This talk presents a mid to long-term result and operative technique on use of a pyrocarbon, non-anatomical implant for arthrosis of the first carpo-metacarpal joint (CMCJ) arthritis.

Methods: Data was collected prospectively for 25 patients (average age 56) with radiological stage I - III arthroses who failed conservative management and underwent interposition arthroplasty over the last 8+ years. Patient satisfaction was high. At the mean follow up of 43 months, pain decreased in all patients from 7.4 to 2.2 and DASH score from 57 to 19 (p < 0.01) whereas pinch and grip strength showed less dramatic improvement from 2.9 to 3.9 kg and 15-19kg (p > 0.05), respectively. Thumb mobility was restored to that of the contralateral thumb at average 7 months post surgery. Two patients had implant dislocations. Both were found to be due to suboptimal technique at the time of primary surgery. One of these patients underwent successful trapeziectomy and another one a revision surgery with larger prostesis. No joint instability or periprosthetic lucency has been observed at this interim period. Results of this single surgeon cohort will be compared against the published literature.

During the presentation a short video will demonstrate actual surgical technique which includes minimal osteotomies of the trapezium and thumb metacarpal base via volar approach and stabilization of the implant and the joint with the sling of the flexor carpi radialis tendon.

Results and Conclusions: Midterm results appear encouraging, but critical analysis of this technique and data collection on long term outcomes and implant survival continues.