Abstract
Background
Thumb carpometacarpal (CMC) arthritis is a common and sometimes debilitating condition
with a variety of surgical treatments. Pyrocarbon thumb CMC hemiarthroplasty is one
option, which has demonstrated promise; however, no long-term outcomes have been reported.
Materials and Methods
We performed a retrospective institutional review of 106 primary thumb CMC pyrocarbon
hemiarthroplasties with a minimum of 1 year, median 6.1-year follow-up. We analyzed
rates of pain relief, reoperation, and implant failure as well as biomechanical, radiographic,
and patient-reported outcomes.
Results
Pain was significantly decreased after surgery. Radial and palmar abduction were modestly
improved postoperatively (increased from 40–50 degrees). Implants showed high rates
of radiographic osteolysis (53%) and subsidence (44%). Two-, 5-, and 10-year rates
of reoperation (18, 21, 21%) and implant removal (15, 19, and 19%), respectively.
Conclusions
Pyrocarbon thumb CMC hemiarthroplasty provides high rates of pain relief and preservation
of pinch and grip strength. Patients had modest improvement in radial and palmar abduction;
however, hemiarthroplasty was associated with moderate rates of reoperation and implant
revision.
Level of Evidence
Therapy Level IV.
Keywords
carpometacarpal arthritis - pyrocarbon - arthroplasty - patient-reported outcomes
