Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the treatment of rhizarthrosis

Cuenca-Llavall, M.; Lizano-Díez, Xavier; Cruz-Sánchez, Marcos; Cebamanos-Celma, J.; Pidemunt-Moli, G.

doi:10.1016/j.recote.2018.07.002

Cited by 3 publications

(8 citation statements)

References 20 publications

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“…The first study showed that at the end of the follow-up period, pain improvement was less in the interposition implant group, and the mean QuickDASH was 31.14 (range: 0-70) in the implant group and 15.81 (range; 8 – 24) in the LRTI group; removal of implant was performed in 6 of the 16 cases. 19 Although the second comparative study, published in 2019, reported similar outcomes in both groups, with an improvement in the VAS pain score from 6.5 and 5.9 preoperatively to 0.7 and 0.8 postoperatively, the mean DASH scores improved from 47.4 to 7.9, and 55.6 to 8.7 in the LRTI and implant groups, respectively. In this study, pinch grip was 1.8 kg higher postoperatively in the implant group, whereas the Kapandji score improved from 7.7 preoperatively in both groups to 9.2 and 9.1 in the LRTI and implant groups, respectively.…”

Section: Resultsmentioning

confidence: 92%

“…Comparative studies between an LRTI procedure and partial trapezial excision and interposition arthroplasty performed with the PyroDisk implant and early results of the Artelon implant and autologous tendon graft, as well as a comparative study of the use of OrthoADAPT, GraftJacket, and Artelon, show pain relief, functional improvement, and patient satisfaction, although none of the interposition materials were superior to the other. 1-21,32 Closer assessment shows that pain improvement and patient satisfaction were lower in the Artelon group, despite improved pinch and tripod grip, compared with the trapeziectomy and LRTI group. 12…”

Section: Discussionmentioning

confidence: 99%

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Systematic Review of Thumb Carpometacarpal Joint Hemiresection Interposition Arthroplasty Materials

Spiteri

Giele

2020

Hand (New York, N,Y.)

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Background Osteoarthritis of the first carpometacarpal joint is a common condition. Various management options and surgical procedures have been described to treat symptomatic cases. Many systematic reviews examine aspects of thumb carpometacarpal joint osteoarthritis treatment, although none solely examines the outcomes of trapezial partial resection and interposition arthroplasty in stage II to III patients in detail, yet this technique is of growing interest as surgeons seek more nuanced, tailored approaches for osteoarthritis of the first carpometacarpal joint. Methods A systematic review of the thumb carpometacarpal joint hemiresection and interposition arthroplasty was performed with pain assessment as a primary outcome measure and patient-reported outcome measures (PROMs) and reoperation rate as secondary outcome measures. A search was performed between 2004 and 2019 using MEDLINE, Embase, and PubMed. Preferred Reporting Items and Systematic Reviews and Meta-Analyses guidelines were used. Results Twenty-nine articles met the inclusion criteria and were included in the final review. Pain relief and improved PROMs were described in all the articles using this technique with all the interposition materials. Materials such as polyurethane urea matrix and poly-l/d-lactide scaffold had higher complication rates. Revision rates varied and were highest with the polyurethane urea matrix. Conclusions This review shows that hemiresection interposition arthroplasty is a useful technique and provides symptomatic benefit in patients with Eaton-Littler stage II and III osteoarthritis. Revision surgery rates due to persistent pain and instability were higher with the use of implants. Larger and long-term studies of this technique using autologous or more bioinert materials and implants are required to assess duration of symptomatic benefit.

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Section: Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Systematic Review of Thumb Carpometacarpal Joint Hemiresection Interposition Arthroplasty Materials

Spiteri

Giele

2020

Hand (New York, N,Y.)

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“…Estos valores coinciden con los de la literatura actual, cuyos valores globales oscilan entre 17 y 31 puntos de promedio. 7,13,14,16,23 Aunque algunos de nuestros pacientes puntuaron hasta 50 y 60 puntos en el QuickDASH, todos refirieron una puntuación de satisfacción entre 8 y 10, y declararon no necesitar cirugía adicional. De hecho, el 76% y el 82% de los pacientes estaban muy satisfechos o completamente satisfechos (puntuación !…”

Section: Discussionunclassified

“…11 La oposición (Kapandji 19 ), una de las características más importantes, fue de 8.47 AE 1.55 de promedio, y coincide con los valores publicados. 7,13,16,23 La relación entre los resultados funcionales y el tiempo de reanudación de las actividades debería ser algo interesante de observar, pero apenas se refiere en la literatura actual. En nuestra serie, sólo 7 de 19 pacientes no estaban jubilados en el momento de la cirugía, con un tiempo medio de vuelta al trabajo de 4.07 AE 2.92 meses.…”

Section: Discussionunclassified

“…Numerosas estrategias quirúrgicas han demostrado ser eficaces en la mayoría de los casos, pero ningún método ha resultado superior a los otros hasta ahora. [2][3][4][5][6] El uso de prótesis de carbono pirolítico ha aumentado durante la última década, 7,8 debido a su biocompatibilidad, su bajo coeficiente de fricción, y su particular módulo de elasticidad, 9,10 que crean un implante de gran fuerza y resistente al desgaste. [10][11][12] Los estudios publicados hasta la fecha presentan discrepantes resultados funcionales a medio plazo: muchos describen resultados favorables, concretamente, un excelente alivio del dolor y la satisfacción del paciente, 4,8,10,13,14 pero algunos informan de altas tasas de fracaso, provenientes de la rotura, la inestabilidad, la dislocación, el aflojamiento y la rigidez.…”

Section: Introductionunclassified

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Pyrocarbon Implant for Trapeziometacarpal Arthritis: Mid-term Clinical and Radiological Results

Ribeiro

Ribau

Ribeiro

et al. 2021

Revista Iberoamericana de Cirugía de la Mano

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Pyrolytic carbon implants for trapeziometacarpal (TMC) arthritis have been extensively studied, but there is still discrepancy in the literature concerning the mid-term functional results. Our group describes the clinical and radiological results after five years of surgical management of TMC arthritis with Pyrodisk (Integra Life Sciences, Plainsboro, NJ, US). A total of 19 patients (2 males and 17 females) aged 56.45 ± 5.95 (range: 44 to 67) years were reviewed with a mean follow-up of 74.05 ± 14.43 (range: 60.00 to 105.83) months. At the final follow-up, the score on the Visual Analogue Scale (VAS) for pain was of 1.76 ± 2.05, the average score on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire was of 22.73 ± 22.33, and all functional parameters were above the 90% barrier of the contralateral side. The progression of radiolucency was 89% at 1 year and 11% at 5 years of follow-up respectively, but it was not related to the clinical outcomes. The prevalence of subluxation (around one-fourth of the center of the implant) was of 24% in asymptomatic patients, and dislocation was not observed. The overall survival of the implant was of 89%. Revision took place in 11% of the cases due to persistent pain and implant breakage after direct impact. More than 75% of the patients were very or highly satisfied with the treatment. In conclusion, Pyrodisk enabled us to obtain good functional mid-term results, with an acceptable survival of the implant and low risk of dislocation. Radiological findings do not necessarily translate into clinical symptoms.

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Pyrocarbon Arthroplasty Implants in the Upper Extremity: A Systematic Review of Outcomes and Pooled Analysis of Complications

Abi‐Rafeh¹,

ElHawary²,

Azzi³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: Growing use of pyrocarbon implants in upper extremity arthroplasty has culminated in a breadth of literature ascertaining outcomes and complications at long-term follow-up. However, at present, the literature remains devoid of studies synthesizing the available evidence for upper extremity surgeons to adequately assess the safety and utility of these implants relative to other available options. Methods: A systematic search of the National Library of Medicine, MEDLINE, and Embase databases was performed to determine clinical outcomes and complication and reoperation rates following pyrocarbon arthroplasties in the upper extremity. A breakdown of complication and reoperation rates for each independent joint (shoulder, elbow, wrist, and hand joints), and according to specific causes necessitating surgery, was also compiled. Results: A comprehensive summary of functional outcomes following upper extremity pyrocarbon arthroplasties is presented. Overall complication and reoperation rates in the hand and wrist were determined to be 28.2 percent and 17 percent, respectively. The proximal interphalangeal joint was associated with the highest complication rate (42.7 percent), followed by carpometacarpal joint (18.8 percent), metacarpophalangeal joint (17.6 percent), wrist (16 percent), elbow (15.7 percent), and shoulder (12.9 percent). In the hand and wrist, major complications included dislocations and subluxations (8.4 percent), stiffness and limited motion (4.4 percent), deformity (3.1 percent), hardware failure (1.9 percent), fractures (1.7 percent), persistent pain (1.7 percent), and infections (0.9 percent). Conclusion: In the absence of large clinical trials, systematic reviews such as these can help inform clinical guidelines and provide practitioners with an evidence-based reference to improve informed consent.

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Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the treatment of rhizarthrosis

Cited by 3 publications

References 20 publications

Systematic Review of Thumb Carpometacarpal Joint Hemiresection Interposition Arthroplasty Materials

Systematic Review of Thumb Carpometacarpal Joint Hemiresection Interposition Arthroplasty Materials

Pyrocarbon Implant for Trapeziometacarpal Arthritis: Mid-term Clinical and Radiological Results

Pyrocarbon Arthroplasty Implants in the Upper Extremity: A Systematic Review of Outcomes and Pooled Analysis of Complications

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