Abstract
Background New and improved surgical techniques are warranted to treat osteoarthritis of the
thumb carpometacarpal joint (CMC-1). The Pyrocardan implant yields striking results
but only few series exist, making the evidence scarce.
Purpose The aim of this study was to conduct a prospective series using the Pyrocardan implant.
Methods We compared the outcomes to a matched historical control group of patients operated
on with ligament reconstruction and tendon interposition. The hypothesis was that
the Pyrocardan implant would yield better patient-reported outcomes as well as the
procedure would be safe and effective in relieving symptoms of CMC-1 osteoarthritis.
In total, 30 patients were included in the prospective series. These 30 patients were
compared, in a 1:3 design, to a matched historical group.
Results Results were promising with visual analogue scale scores of 0.7 (rest) and 2.1 (function),
key-pinch score of 5.1 kg, and shortened Disability of the Arm, Shoulder, and Hand
score of 14.3 after 1 year when using the Pyrocardan implant. The revision rate was
10%. We found no evidence of subsidence of the thumb. We found no differences in patient-reported
outcomes between the two groups.
Conclusions In conclusion, the Pyrocardan implant is a viable option in the treatment of CMC-1
osteoarthritis but with a significant revision rate. When comparing the Pyrocardan
implant to a historical control group, we failed to find any differences in patient-reported
outcomes.
Level of Evidence IV – case series.
Keywords
Pyrocarbon - Quick-DASH - patient-reported outcome - thumb carpometacarpal joint osteoarthritis
