A ten-year prospective outcome study of Pi2 pyrocarbon spacer arthroplasty in carpometacarpal joint osteoarthritis

Abstract

Surgical management of carpometacarpal osteoarthritis may use many techniques. Pi2 (pyrocarbon interposition implant) arthroplasty is one possible solution after total trapeziectomy. The present study assessed clinical and radiological results in Pi2 arthroplasty at a minimum 10years' follow-up. Forty-two consecutive cases underwent surgery between March 2003 and April 2005; 29 were followed up for a mean of 125.49months (10.5years). A total of 96.6% of patients were very satisfied or satisfied. Range of motion improved, especially in opposition (mean Kapandji score, 9.60), with no major aggravation of metacarpophalangeal extension. Postoperative pinch strength was 5.9kg and grip 24.2kg. Mean time to resuming daily activities was 76days (range, 30-240days). At last follow-up, mean QuickDash score was 19.9 and overall PWRE score 16.4 out of 100. Bone remodeling, mainly in the scaphoid, was found in 48.2% of cases, and was stable between 5 and 10years, with no clinical or functional significance. Two implant dislocations (4.6%) occurred, not requiring surgical revision. Implant survival was 100%. The results of free Pi2 arthroplasty at more than 10years confirmed that this is a valid solution for the treatment of advanced carpometacarpal osteoarthritis, on condition that surgical technique is very precise.

Keywords: Arthrose trapézo-métacarpienne; Carpometacarpal osteoarthritis; Implant Pi2; Pi2 implant; Pyrocarbon; Pyrocarbone; Trapeziectomy; Trapézectomie.