Poor results with pyrocarbon implants

Pyrolytic carbon arthroplasty (PCA) has a high incidence of complications, poor outcomes, and variable patient satisfaction at long-term follow-up, according to Thomas M. Sweets, MD, and should not be recommended for treatment of osteoarthritis of the proximal interphalangeal (PIP) joint.

The results of a retrospective review conducted by Dr. Sweets and fellow researcher, Peter J. Stern, MD, found that patients who had received PCA of the PIP joint had decreased range of motion (ROM), lower functional scores, and increased pain in the operated hand compared to the contralateral hand after an average 55-month follow-up. The 17 patients in the study had a diagnosis of primary osteoarthritis, and all surgeries were performed by a single surgeon prior to October 2007.

The average age at surgery was 64 years, and 30 of the 31 joints belonged to women. Implants had been placed in 7 index fingers, 14 long fingers, 8 ring fingers, and 2 small fingers. All patients had preoperative coronal angulation less than 20 degrees, adequate bone stock, and intact collateral ligaments.

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