Small Joint Replacements With Pyrocarbon Implants — They're Still in the Mix

A well-reported series with near-complete follow-up can help you counsel patients about this less-frequently used alternative

What’s the Claim?

An uncommonly well-reported and complete case series looked at mid- to long-term follow-up of pyrocarbon hemiarthroplasty for proximal interphalangeal joint arthritis and found at a minimum of 6-year (mean of 11-year) follow-up:

  • Implant survivorship was 79% at 5 years and estimated to be 72% at 10 years; about one in five developed a swan-neck deformity, but no patient opted for revision surgery to address that problem
  • VAS pain scores with activity remained substantially improved (from 7 out of 10 to 0 out of 10)
  • ROM gains, especially at the PIP joint (but also at the DIP), were sustained over time and were probably clinically important (30° at the PIP and 15° at the DIP); however, DASH score “improvements” were probably not clinically important, perhaps because of other arthritic conditions in the same hands.

How’s It Stack Up?