Abstract
Purpose
Trapeziometacarpal (TM) osteoarthritis is the most common type of arthritis of the hand. To date, among surgical alternatives proposed, no one type has been proven superior to others. In this prospective study we evaluated the efficacy of treating arthroplasty with a latest-generation pyrocarbon implant (Pyrocardan).
Methods
Thirty-six patients with TM arthritis were treated using Pyrocardan implant arthroplasty. Results were evaluated through thumb radial and palmar abduction assessment, key pinch strength evaluation, thumb opposition assessment according to Kapandji classification, the visual analogue scale, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Patient’s Satisfaction Index.
Results
There was substantial pain reduction and a satisfying increase in range of motion and strength (p < 0.01) and improvement in DASH score (p < 0.01). Average Patient’s Satisfaction Index was 8 out of 10.
Conclusions
TM arthroplasty with Pyrocardan implantation is a suitable option in treating Eaton-Littler grade II or III TM osteoarthritis.
Similar content being viewed by others
References
Szalay G, Meyer C, Scheufens T, Schnettler R, Christ R, Schleicher I (2013) Pyrocarbon spacer as a trapezium replacement for arthritis of the trapeziometacarpal joint; a follow-up study of 60 cases. Acta Orthop Belg 79(6):648–654
Vázquez-Alonso MF, Briseño-Pérez J, Tovar-Beltrán O, Esquivel-Vázquez N (2011) Trapeziometacarpal arthrodesis. Overall functional hand assessment. Acta Ortop Mex 25(6):372–375
Frizziero A, Maffulli N, Masiero S, Frizziero L (2014) Six-months pain relief and functional recovery after intra-articular injections with hyaluronic acid (mw 500–730 kda) in trapeziometacarpal osteoarthritis. Muscles Ligaments Tendons J 4:256–261
Li YK, White C, Ignacy TA, Thoma A (2011) Comparison of trapeziectomy and trapeziectomy with ligament reconstruction and tendon interposition: a systematic literature review. Plast Reconstr Surg 128(1):199–207
Gangopadhyay S, McKenna H, Burke FD, Davis TR (2012) Five- to 18-year follow-up for treatment of trapeziometacarpalosteoarthritis: a prospective comparison of excision, tendon interposition, and ligament reconstruction and tendon interposition. J Hand Surg Am 37(3):411–417
Hentz VR (2014) Surgical treatment of trapeziometacarpal joint arthritis: a historical perspective. Clin Orthop Relat Res 472(4):1184–1189
Swanson AB, deGoot SG, Watermeier JJ (1981) Trapezium implant arthroplasty. Long-term evaluation of 150 cases. J Hand Surg Am 6:125–141
MacDermid JC, Roth JH, Rampersaud YR, Bain GI (2003) Trapezial arthroplasty with silicone rubber implantation for advanced osteoarthritis of the trapeziometacarpal joint of the thumb. Can J Surg 46(2):103–110
Jorheim M, Isaxon I, Flondell M, Kalén P, Atroshi I (2009) Short-term outcomes of trapeziometacarpal artelon implant compared with tendon suspension interposition arthroplasty for osteoarthritis: a matched cohort study. J Hand Surg Am 34(8):1381–1387
De Smet L, Sioen W, Spaepen D, Van Ransbeeck H (2004) Total joint arthroplasty for osteoarthritis of the thumb basal joint. Acta Orthop Belg 70(1):19–24
Ferrari B, Steffee AD (1986) Trapeziometacarpal total joint replacement using the Steffee prosthesis. J Bone Joint Surg Am 68(8):1177–1184
Regnard PJ (2006) Electra trapezio metacarpal prosthesis: results of the first 100 cases. J Hand Surg Br 31(6):621–628
Badia A, Sambandam SN (2006) Total joint arthroplasty in the treatment of advanced stages of thumb carpometacarpal joint osteoarthritis. J Hand Surg Am 31(10):1605–1614
Ledoux P (1997) Failure of total uncemented trapeziometacarpal prosthesis. A multicentre study. Ann Chir Main Memb Super 16(3):215–221
Cooney WP, Linscheid RL, Askew LJ (1987) Total arthroplasty of the thumb trapeziometacarpal joint. Clin Orthop Relat Res 220:35–45
Pérez-Úbeda MJ, García-López A, Marco Martinez F, Junyent Vilanova E, Molina Martos M, López-Duran Stern L (2003) Results of the cemented SR trapeziometacarpal prosthesis in the treatment of thumb carpometacarpal osteoarthritis. J Hand Surg Am 28(6):917–925
Maru M, Jettoo P, Tourret L, Jones M, Irwin L (2012) Thumb carpometacarpal osteoarthritis: trapeziectomy versus pyrocarbon interposition implant (Pi2) arthroplasty. J Hand Surg Eur 37(7):617–620
Eaton RG, Lane LB, Littler JW, Keyser JJ (1984) Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg Am 9(5):692–699
Burton RI, Pellegrini VD Jr (1986) Surgical management of basal joint arthritis of the thumb. Part II. Ligament reconstruction with tendon interposition arthroplasty. J Hand Surg Am 11:324–332
Maffulli N, Irwin AS, Chesney RB (1997) Modified Burton and Pellegrini procedure for trapezium excision, ligament reconstruction and interposition arthroplasty of the tendon of flexor carpi radialis. Oper Orthopaedie Traumatol 9:69–79
Rizzo M, Moran SL, Shin AY (2009) Long-term outcomes of trapeziometacarpal arthrodesis in the management of trapeziometacarpal arthritis. J Hand Surg Am 34(1):20–26
Vermeulen GM, Slijper H, Feitz R, Hovius SE, Moojen TM, Selles RW (2011) Surgical management of primary thumb carpometacarpal osteoarthritis: a systematic review. J Hand Surg Am 36(1):157–169
De Smet L, Vaes F, Van Den Broecke J (2005) Arthrodesis of the trapeziometacarpal joint for basal joint osteoarthritis of the thumb: the importance of obtaining osseous union. Chir Main 24(5):222–224
Singh HP, Hoare C, Beresford-Cleary N, Anakwe R, Hayton M (2015) Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation. J Hand Surg Eur 40(4):351–355
De Smet L, Van Meir N, Verhoeven N, Degreef I (2010) Is there still a place for arthrodesis in the surgical treatment of basal joint osteoarthritis of the thumb? Acta Orthop Belg 76(6):719–724
Vinycomb T, Crock J (2013) Trapeziectomy with ligament reconstruction and tendon interposition: a minimum 10-year follow-up. Hand Surg 18(3):365–368
Wilchinsky ME, Malek N (1984) Functional evaluation of tendon interposition arthroplasty of the trapeziometacarpal joint. Orthopedics 7(6):971–976
Eaton RG, Glickel SZ, Littler JW (1985) Tendon interposition arthroplasty for degenerative arthritis of thetrapeziometacarpal joint of the thumb. J Hand Surg Am 10(5):645–654
Vermeulen GM, Brink SM, Slijper H, Feitz R, Moojen TM, Hovius SE, Selles RW (2014) Trapeziometacarpal arthrodesis or trapeziectomy with ligament reconstruction in primary trapeziometacarpal osteoarthritis: a randomized controlled trial. J Bone Joint Surg Am 96(9):726–733
Irwin AS, Maffulli N, Chesney RB (1995) Scapho-trapezoid arthritis. A cause of residual pain after arthroplasty of the trapezio-metacarpal joint. J Hand Surg Br 20-B:346–352
Cook SD, Beckenbaugh RD, Redondo J, Popich LS, Klawitter JJ, Linscheid RL (1999) Long-term follow-up of pyrolytic carbon metacarpophalangeal implants. J Bone Joint Surg Am 81(5):635–648
Mariconda M, Russo S, Smeraglia F, Busco G (2014) Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up. J Hand Surg Eur 39(6):604–610
Odella S, Queringhi AM, Sartore R, De Felice A, Dacatra U (2014) Trapeziometacarpal osteoarthritis: pyrocarbon interposition implants. Joints 2(4):154–158
Barrera-Ochoa S, Vidal-Tarrason N, Correa-Vázquez E, Reverte-Vinaixa MM, Font-Segura J, Mir-Bullo X (2014) Pyrocarbon interposition (PyroDisk) implant for trapeziometacarpal osteoarthritis: minimum 5-year follow-up. J Hand Surg Am 39(11):2150–2160
Szalay G, Meyer C, Kraus R, Heiss C, Schnettler R (2009) The operative treatment of rhizarthrosis with pyrocarbon spacer as replacement of the trapezium. Handchir Mikrochir Plasr Chir 41(5):300–305
Van Aaken J, Holzer N, Wehrli L (2011) High failure rate treating CMC 1 osteoarthritis with PI2 pyrocarbon prosthesis. J Hand Surg Eur 36(Suppl 1):S45–S56
Martinez de Aragon JS, Moran SL, Rizzo M, Reggin KB, Beckenbaugh RD (2009) Early outcomes of pyrolytic carbon hemiarthroplasty for the treatment of trapezial-metacarpal arthritis. J Hand Surg Am 34(2):205–212
Bellemère P, Gaisne E, Loubersac T, Ardouin L, Collon S, Maes C (2011) Pyrocardan implant: free pyrocarbon interposition for resurfacing trapeziometacarpal joint. Chir Main 30(S1):28–35
Martin-Ferrero M (2014) Ten-year long-term results of total joint arthroplasties with ARPE® implant in the treatment of trapeziometacarpal osteoarthritis. J Hand Surg Eur 39(8):826–832
Goubau JF, Goorens CK, Van Hoonacker P, Berghs B, Kerckhove D, Scheerlinck T (2013) Clinical and radiological outcomes of the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis with a minimum of 5 years of follow-up: a prospective single-centre cohort study. J Hand Surg Eur 38(8):866–874
Downing ND, Davis TR (2001) Trapezial space height after trapeziectomy: mechanism of formation and benefits. J Hand Surg Am 26(5):862–868
Trumble T, Rafijah G, Heaton D (2013) Thumb carpometacarpal arthroplasty with ligament reconstruction and interposition costochondral arthroplasty. J Wrist Surg 2(3):220–227
Wolf JM, Delaronde S (2012) Current trends in nonoperative and operative treatment of trapeziometacarpal osteoarthritis: a survey of US hand surgeons. J Hand Surg Am 37(1):77–82
Igoe D, Middleton C, Hammert W (2014) Evolution of basal joint arthroplasty and technology in hand surgery. J Hand Ther: Off J Am Soc Hand Ther 27(2):115–120
Acknowledgments
The authors thank Nicola Maffulli for his contribution to the study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosure of interest
None of the authors has a conflict of interest that could inappropriately influence this work.
Rights and permissions
About this article
Cite this article
Russo, S., Bernasconi, A., Busco, G. et al. Treatment of the trapeziometacarpal osteoarthritis by arthroplasty with a pyrocarbon implant. International Orthopaedics (SICOT) 40, 1465–1471 (2016). https://doi.org/10.1007/s00264-015-3016-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-015-3016-z