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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Short to mid-term result of Pyrocarbon implant in the TMC 1 joint for osteoarthritis

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  • presenting/speaker Allan Ibsen Sorensen - Sahlgrenska University Hospital, Gothenburg, Sweden
  • Anders Nilsson - Sahlgrenska University Hospital, Gothenburg, Sweden

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-959

doi: 10.3205/19ifssh0875, urn:nbn:de:0183-19ifssh08751

Published: February 6, 2020

© 2020 Ibsen Sorensen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The aim of the study is to present short to mid-term results of a Pyrocarbon implant (Pyrocardan) in the trapeziometacarpal joint (TMC).

Methods: A pyro-disc was used as a spacer in the TMC joint between first metacarpal bone and trapezium bone to treat osteoarthritis. Minimal resections performed of the base of first metacarpal and trapezium bone. A cast was used for 4 weeks, and then unloaded rehabilitation of exercises in 3 weeks followed by 3 weeks with gradually loading. Heavy load was allowed 12 weeks postop.

All patients were evaluated preop, 6, 12 and 26 weeks postoperatively and then yearly with ROM, grip strength, pinch, key-pinch, VAS scores for pain, Quick-DASH and patients satisfaction. X-Ray performed preop, 3 months postop and thereafter yearly.

Thirty-six patients were operated 18 men and 18 women. Median age 59 years (45-79). Four additional operations of IP and or MP1 joint and seven on wrist or hand. One patient operated later with arthrodesis in MP1 joint in same thumb. Mean values are used.

Results and Conclusions: Follow-up was 21 months (range 3-52). Radial abduction/palmar abduction was preop 38/39 degrees and at follow-up 40/40. Thumb opposition was .5 cm (0-3.0) versus .7 (0-6.0) Last follow-up (LFU) (P=NS). Grip strength in KgF preop was 22 (range 1-76) and at LFU 24 (7-69) (P=NS). Pinch/key-pinch (Kg) preop were 4.3/3.4 and at LFU 4.5/5.1 (P=NS). VAS pain (mm) was preop at rest/activity: 47/78 and at LFU: 20/35 (P<.01). Quick DASH preop; 52 (16-86) and at LFU; 33 (0-86) (p<0.01). Satisfaction (mm of 100) preop: 17 (0-94) was improved at LFU: 71 (0-100) (p<0.01). Radiographic migration occurred in two implant but it was not dislocated.

No infection. Four implants were revised, two to tendon interposition arthroplasty and two to change of the size of the implant and MiniTightRope joint stabilization. One MiniTightRope joint stabilization were performed due to instability.

Short to mid-term results with a pyrocarbon implant in the TMC joint concerning pain, Quick-DASH and patient satisfaction are favorable. Change of other outcome data were non-significant. Longer follow-up and a larger series of patients operated on with this implant is needed.