Grégoire Chiarella , Ludovic Ardouin , Flore-Anne Lecoq , Clara Sos , Philippe Bellemère
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Abstract
Objective
We present long-term results for the Pyrocardan®, a pyrocarbon trapeziometacarpal interposition implant used for the treatment of osteoarthritis of the thumb.
Methods
Between March 2009 and May 2013, 199 arthroplasties were performed in a single hand center, in 184 patients by 6 hand surgeons.
107 implants were followed up for a mean 137 months (range, 120–168 months). 82 patients (89 implants) were lost to follow-up.
Results
Median age was 57 years, with 15 patients (14.2%) aged ≤50 years.
At last follow-up, functional scores were significantly improved compared to preoperative data: pain rating, 0.4/10 versus 7.2/10; Patient-Rated Wrist/Hand Evaluation, 4/100 versus 61/100; Quick Disabilities of the Arm, Shoulder and Hand, 9/100 versus 54/100.
Range of motion and strength were comparable to the contralateral side. Radiographic analysis showed that 82% of implants were correctly positioned. No implant dislocation was observed. There were 6 re-operations, 5 of which in the short term.
Overall implant survival was 94.3%, with 44.7% loss to follow-up.
Conclusion
Pyrocardan® interposition arthroplasty is a valid alternative for the treatment of osteoarthritis of the thumb.
目的：我们介绍了Pyrocardan®的长期疗效，Pyrocardan®是一种用于治疗拇指骨关节炎的焦碳梯形胸骨间置植入物。方法：2009年3月至2013年5月，6名手外科医生在单手中心行关节置换术199例，184例患者。107例种植体平均随访137个月（120 ~ 168个月）。82例患者（89枚植入物）失访。结果：中位年龄为57岁，年龄≤50岁15例（14.2%）。最后一次随访时，与术前数据相比，功能评分显著提高：疼痛评分为0.4/10比7.2/10；患者评价腕/手评价，4/100 vs 61/100；手臂，肩膀和手的快速残疾，9/100对54/100。活动范围和力量与对侧相当。x线分析显示82%的植入物定位正确。未见种植体脱位。再次手术6例，其中5例为短期手术。种植体总体存活率为94.3%，随访损失44.7%。结论：Pyrocardan®人工关节置换术是治疗拇指骨性关节炎的有效方法。证据等级：四级。
期刊介绍：
As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented.
Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.
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