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STT Pyrocarbon Arthroplasty

26 citationsUpdated Oct 2026
Illustration: hand

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

The Pyrocardan® implant serves as a resurfacing arthroplasty option for isolated scaphotrapezial (STT) osteoarthritis, offering a reliable alternative to trapeziectomy, total arthroplasty, or fusion, particularly for young, active patients [6]. This procedure avoids the loss of mobility associated with fusion [5] and maintains midcarpal mobility through spacer use [5]. The implant is characterized by a simple surgical procedure that does not require fixation or ligamentoplasty [2]. Clinical outcomes demonstrate reduced pain, improved strength and functional scores, and restored wrist stability [1]. Radiographic and functional results are consistently reported as good, with an absence of surgical technique complications [4, 15]. Surgical treatment of isolated STT osteoarthritis resistant to conservative management leads to significant functional improvement, particularly in pain, without altering the wrist’s overall mobility [14].

The Pyrocardan® implant is also indicated for more extensive disease. In patients with early-stage pantrapezial osteoarthritis with preserved trapezium structure, double STT and TM pyrocarbon interposition offers good midterm results [3]. Simultaneous dual prosthetic replacement of the trapeziometacarpal and scaphotrapezial-trapezoid joints preserves carpal stability and thumb function, achieving favorable functional outcomes with a low complication rate [7]. The implant may be contraindicated in patients with symptomatic STT osteoarthritis who intend to continue high-load activities involving wrist extension under load, such as tennis [8].

Surgical options for STT arthritis depend on the specific clinical scenario [12]. Isolated STT arthritis is often managed by distal scaphoid resection or arthrodesis [12], while cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision [12]. STT joint fusion typically produces 75% range of movement of the non-operated wrist but carries a higher associated complication rate [10]. Simultaneous radial styloidectomy is recommended to reduce ongoing pain from impingement in STT joint fusion [10]. No surgical option for scaphotrapeziotrapezoidal joint osteoarthritis has clear evidence of superiority [9]. Pyrocardan interposition arthroplasty appears to be a safe and effective treatment for trapeziometacarpal arthritis [13].

Anatomy & Pathophysiology

Bony Anatomy

The hand and wrist skeleton comprises 27 bones, 19 of which are long bones [21]. The radial ray, or first ray, is the shortest and consists of a metacarpal and two phalanges [21]. This ray continues the external column of the carpus formed by the scaphoid and trapezium [21]. The trapezium is angled out in front of the carpal plane, causing the first metacarpal to form an angle of approximately 45 degrees with the second metacarpal in the sagittal plane [21]. The thumb metacarpal is independent and articulates with the trapezium [27]. The base of each metacarpal articulates with the distal row of the carpus, while the carpus articulates with the forearm skeleton through its proximal row [21].

Functional Anatomy & Kinematics

The wrist possesses three axes of movement, allowing the hand to assume any spatial configuration [21]. The first ray exhibits relative autonomy due to scapholunate mobility [21]. The thumb ray is more mobile, shorter, and more proximal than the other rays, enabling it to project in front of the palm plane to oppose the other four rays [21]. The metacarpal arch demonstrates significant adaptability owing to the mobility of the peripheral metacarpals [27]. Within this arch, the index metacarpal is the most firmly fixed [27], whereas the fifth metacarpal has a flexion–extension range of approximately 20 degrees [27].

Single articular movements around a fixed perpendicular axis do not exist in the hand [32]. Almost all hand movements occur around oblique and variable axes, resulting in combined movements that permit optimal phalangeal orientation during prehension [32]. The position of each articulation depends on the equilibrium of forces acting at that level, which is subject to the position of the immediately proximal articulation [32].

Musculature & Tendon Anatomy

Extrinsic muscles originate outside the hand and insert on the hand or carpus, whereas intrinsic muscles have both origin and insertion within the hand [20]. The extrinsic extensors traverse six fibroosseous retinacular compartments at the wrist [20]. The first (most radial) compartment contains the abductor pollicis longus and extensor pollicis brevis [20]. The second compartment contains the extensor carpi radialis longus and brevis [20]. The third compartment contains the extensor pollicis longus, which turns abruptly radialward about Lister tubercle [20]. The fourth compartment contains the extensor indicis proprius, lying deep to the four tendons of the extensor digitorum communis [20]. The fifth compartment contains the extensor digiti quinti [20]. The extensor carpi ulnaris tendon runs through the sixth compartment and inserts at the base of the little finger metacarpal [20].

There are seven interosseous muscles: four dorsal and three volar [24]. The dorsal interossei act as abductors, while the volar interossei act as adductors [24]. The middle finger possesses two dorsal interossei and no volar interossei because the central axis of the hand lies within it [24]. The flexor digitorum profundus originates from the proximal ulna and interosseous membrane [31]. The flexor digitorum superficialis has two heads: a radial head from the proximal radius shaft, and a humeral ulnar head from the medial humeral epicondyle and coronoid process of the ulna [31]. The flexor pollicis longus originates from a radial head (proximal radius and interosseous membrane) and an accessory head (coronoid process of the ulna and medial epicondyle of the humerus) [31]. The A2 and A4 pulleys are the most essential for maintaining the mechanical advantage of the flexor tendons [31].

Vascular & Neurological Anatomy

The "princeps pollicis" artery, a terminal branch of the radial artery, crosses the first intermetacarpal space and runs along the ulnar side of the first metacarpal bone [28]. It divides into two terminal rami, the collateral palmar arteries of the thumb, at the level of the cutaneous flexion crease of the metacarpophalangeal joint [28]. The most important structure in the thenar area is the recurrent branch (motor) of the median nerve [29]. Anatomic studies indicate that no single longitudinal incision in the proximal palm completely avoids the palmar cutaneous branches of the median and ulnar nerves [29]. The tenosynovial sheath of the flexor pollicis longus is continuous with the radial bursa [31]. The tenosynovial sheath to the little finger is continuous with the ulnar digital bursa [31].

Pathophysiology & Clinical Implications

STT joint fusion typically produces 75% of the range of movement of the non-operated wrist but carries a higher associated complication rate [10]. The Pyrocardan implant may be contraindicated in patients with symptomatic STT osteoarthritis who intend to continue high-load activities, particularly those involving wrist extension under load, such as tennis [8]. Surgical options for scaphotrapeziotrapezoidal joint osteoarthritis are numerous, but none has clear evidence of superiority [9]. Management of STT arthritis depends on the specific clinical scenario, with isolated cases often managed by distal scaphoid resection or arthrodesis [12].

Classification

Other Considerations: Isolated STT arthritis cases are often managed by distal scaphoid resection or arthrodesis [12]. Cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision [12].

Clinical Presentation

Surgical management of scaphotrapezial (STT) arthritis is dictated by the specific clinical scenario. Isolated cases are typically managed with distal scaphoid resection or arthrodesis [12]. When basal joint arthritis is present, trapeziectomy combined with partial trapezoid or distal scaphoid excision is effective [12]. A survey among European hand surgeons provides insight into the surgical management of isolated STT osteoarthritis [11].

For isolated STT osteoarthritis resistant to conservative treatment, surgical intervention leads to significant functional improvement, particularly in pain, without altering overall wrist mobility [14]. The Scaphoid Trapezium Pyrocarbon Implant avoids the loss of mobility associated with fusion procedures while maintaining midcarpal mobility [5]. The Pyrocardan® implant for STT arthrosis requires no fixation or ligamentoplasty [2] and is associated with an absence of complications [2].

Pyrocarbon Arthroplasty Outcomes: * STT arthrodesis and Pyrocardan® implant treatment for isolated STT osteoarthritis results in less pain, better strength and functional scores, and restored wrist stability [1]. * The Pyrocardan® resurfacing implant is a valid option for STT osteoarthritis based on good functional and radiographic outcomes and the absence of surgical complications [4]. * Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis [13].

Extended Indications: * Double STT and TM pyrocarbon interposition offers good midterm results in patients with early-stage pantrapezial osteoarthritis and preserved trapezium structure [3]. * Simultaneous dual prosthetic replacement of trapeziometacarpal and scaphotrapezial-trapezoid joints achieves favorable functional outcomes and a low complication rate [7]. * This simultaneous dual replacement is a potentially superior alternative for patients with high functional demands or those requiring durable long-term results [7].

Alternative Implants: * The use of a titanium implant for unipolar resurfacing of the scaphoid in STT arthritis is a recent experience with encouraging results [16].

Investigations

Clinical Evaluation: A systematic approach to the physical examination is essential given the density of structures within the small space of the hand and wrist [19]. Clinical evaluation requires combining patient history with a careful physical examination to pinpoint or narrow the scope of possible pathologic processes [19]. While diagnostic tests such as imaging and serum laboratory studies are useful in determining pathology, they can be expensive, time consuming, and often nonspecific [19].

Plain Radiography: The radiological aspect of the STT joint is staged according to the method described by Smith et al. [17]. The scapholunate angle is measured on a lateral X-ray view preoperatively and at 2 years follow-up to search for any sign of DISI deformity progression [17].

Treatment

Isolated STT Osteoarthritis

Indications: The Pyrocardan™ resurfacing implant is a preferred option in the therapeutic arsenal for STT osteoarthritis due to good functional and radiological results and the absence of surgical technique complications [15]. This approach is suitable for patients with isolated STT osteoarthritis who require restored wrist stability and improved functional scores [1].

Surgical Approach / Technique: The Pyrocardan® implant procedure is a simple surgical procedure with an absence of complications [2]. The application of the pyrocarbon implant for STT arthrosis does not require fixation or ligamentoplasty [2].

Implant Selection: STT arthrodesis and Pyrocardan® implant treatment for isolated STT osteoarthritis resulted in less pain, better strength and functional scores, and restored wrist stability [1]. The use of a spacer in STT arthroplasty maintains midcarpal mobility while avoiding the loss of mobility associated with fusion procedures [5]. The use of a titanium implant for unipolar scaphoid resurfacing in STT osteoarthritis is a recent experience with encouraging results [16].

Pantrapezial and Combined Arthritis

Indications: The combined implant strategy for pantrapezial osteoarthritis is a potentially superior alternative for patients with high functional demands or those requiring durable long-term results [7].

Complications

Other Considerations: STT joint fusion carries a higher associated complication rate compared to other options [10]. To mitigate ongoing pain from impingement following STT joint fusion, simultaneous radial styloidectomy is recommended [10]. The Pyrocardan implant may be contraindicated in patients with symptomatic STT osteoarthritis who intend to continue high-load activities, particularly those involving wrist extension under load, such as tennis [8].

Recovery

Light activity (weeks): The provided evidence does not specify a typical week range for the resumption of desk work, driving, or light activities of daily living.

Full activity (months): The provided evidence does not specify a month range for the return to manual work, sport, or full range of motion and strength.

Complete recovery / outcome plateau (months): The provided evidence does not specify a month range for the stabilization of pain, strength, and final functional outcomes.

Rehabilitation protocol: The application of the pyrocarbon implant for STT arthrosis does not require any fixation nor ligamentoplasty [2]. The use of a spacer maintains midcarpal mobility, avoiding the loss of mobility associated with fusion procedures [5].

Functional milestones: STT arthrodesis and Pyrocardan® implant treatment for isolated STT osteoarthritis led to less pain, better strength and functional scores, and restored wrist stability [1]. The Pyrocardan® resurfacing implant provides good functional and radiographic outcomes with an absence of surgical complications [4]. The Pyrocardan™ resurfacing implant provides good functional and radiological results with an absence of surgical technique complications [15]. Simultaneous dual prosthetic replacement of TMC and STT joints preserves carpal stability and thumb function, achieving favorable functional outcomes and a low complication rate [7].

Other Considerations: Double STT and TM pyrocarbon interposition offers good results at midterm in patients with early stages of pantrapezial OA with preserved trapezium structure [3].

Key Evidence

  • [L4] STT arthrodesis and Pyrocardan® implant to treat isolated STT osteoarthritis led to less pain, better strength and functional scores, and restored wrist stability. [1] (10.1016/j.otsr.2024.103867)
  • [L4] The good results, the simple surgical procedure and the absence of complication confirm the application of this pyrocarbon implant in the treatment of STT arthrosis, which furthermore does not require any fixation nor ligamentoplasty. [2] (10.1016/s0363-5023(03)80381-7)
  • [L4] The double STT and TM pyrocarbon interposition offers good results at midterm on patients suffering from early stages of pantrapezial OA with preserved trapezium structure. [3] (10.1016/j.otsr.2021.102979)
  • [L3] The good functional and radiographic outcomes, and the absence of surgical complications are evidence that the Pyrocardan1 resurfacing implant is a valid option for treating STT osteoarthritis. [4] (10.1016/j.hansur.2017.01.003)
  • [L4] It avoids the loss of mobility of fusion procedures, while the use of a spacer maintains midcarpal mobility. [5] (10.1016/j.jhsb.2006.05.006)
  • [L4] Pyrocardan 1 interposition implant arthroplasty is a reliable alternative to trapeziectomy, total arthroplasty or fusion of the TMC joint especially for young, active patients. [6] (10.1016/j.hansur.2020.09.003)
  • [L4] By preserving carpal stability and thumb function, this approach achieves favorable functional outcomes and a low complication rate, making it a potentially superior alternative for patients with high functional demands or those requiring durable long-term results. [7] (10.1016/j.jhsa.2025.12.013)
  • [Case_report] The Pyrocardan implant may be contraindicated in patients with symptomatic STT OA who intend to continue high-load activities, particularly those involving wrist extension under load, such as tennis. [8] (10.1016/j.jhsg.2026.100964)
  • [L5] Surgical options for scaphotrapeziotrapezoidal joint osteoarthritis are numerous, but none has clear evidence of superiority. [9] (10.1177/17531934241295345)
  • [L1] STT joint fusion typically produces 75% range of movement of the non-operated wrist but has a higher associated complication rate, and simultaneous radial styloidectomy is recommended to reduce ongoing pain from impingement. [10] (10.1142/s0218810417300017)
  • [L4] This survey provides an insight into the surgical management of isolated STT OA among hand surgeons in Europe. [11] (10.1055/s-0039-3402796)
  • [L5] Surgical options for STT arthritis depend on the specific clinical scenario, with isolated cases often managed by distal scaphoid resection or arthrodesis, while cases with basal joint arthritis are effectively managed with trapeziectomy and partial trapezoid or distal scaphoid excision. [12] (10.5435/jaaos-d-19-00539)
  • [L3] Pyrocardan interposition arthroplasty appears to be a safe, effective treatment for trapeziometacarpal arthritis. [13] (10.1055/s-0040-1714685)
  • [L4] Surgical treatment of isolated STT osteoarthritis resistant to conservative treatment leads to significant functional improvement, particularly in terms of pain, without altering the wrist’s overall mobility. [14] (10.1016/j.hansur.2019.11.005)
  • [L4] Les bons résultats fonctionnels et radiologiques, l’absence de complications de la technique chirurgicale font du resurfaçage par implant libre Pyrocardan™ une option de choix dans l’arsenal thérapeutique de l’arthrose STT. [15] (10.1016/j.hansur.2016.10.021)
  • [L4] L’utilisation d’un implant en titane pour le resurfaçage unipolaire du scaphoïde dans l’arthrose de la STT est une expérience récente, pourtant les résultats de notre série semblent encourageants. [16] (10.1016/j.main.2015.10.063)
  • [L2] [17] (10.1055/s-0036-1572539)

See Also

References

[1] Comparison between scaphotrapeziotrapezoid arthrodesis and Pyrocardan® implant for isolated scaphotrapeziotrapezoid osteoarthritis. Orthopaedics & Traumatology: Surgery & Research. 2025. DOI: 10.1016/j.otsr.2024.103867

[2] STT pyrocarbon implant: Preliminary results. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)80381-7

[3] Double trapeziometacarpal and scaphotrapeziotrapezoidal pyrocarbon interposition implants for pantrapezial arthritis: Midterm results and surgical technique. Orthopaedics & Traumatology: Surgery & Research. 2021. DOI: 10.1016/j.otsr.2021.102979

[4] Treatment of scaphotrapeziotrapezoid osteoarthritis with the Pyrocardan® implant: Results with a minimum follow-up of 2 years. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.01.003

[5] Scaphotrapeziotrapezoid Joint Arthritis: A Pilot Study of Treatment with the Scaphoid Trapezium Pyrocarbon Implant. Journal of Hand Surgery. 2006. DOI: 10.1016/j.jhsb.2006.05.006

[6] Pyrocardan® implant arthroplasty for trapeziometacarpal osteoarthritis with a minimum follow-up of 5 years. Hand Surgery and Rehabilitation. 2020. DOI: 10.1016/j.hansur.2020.09.003

[7] Simultaneous Dual Prosthetic Replacement of Trapeziometacarpal and Scaphotrapezial-Trapezoid Joints in Pantrapezial Osteoarthritis: Midterm Results of a Combined Implant Strategy. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2025.12.013

[8] Game, Set… Revision! A Case Report of a Tennis Player Who Smashed His Scaphotrapeziotrapezoid-Joint Pyrocardan Implant Twice. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100964

[9] Surgical options and outcomes for treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934241295345

[10] Scaphotrapeziotrapezoidal Joint Osteoarthritis: A Systematic Review of Surgical Treatment. The Journal of Hand Surgery (Asian-Pacific Volume). 2017. DOI: 10.1142/s0218810417300017

[11] Current Trends in Operative Treatment of Scaphotrapeziotrapezoid Osteoarthritis: A Survey among European Hand Surgeons. Journal of Wrist Surgery. 2020. DOI: 10.1055/s-0039-3402796

[12] Surgical Management of Scaphotrapeziotrapezoid Arthritis. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-19-00539

[13] Pyrocardan Trapeziometacarpal Joint Arthroplasty—Medium-Term Outcomes. Journal of Wrist Surgery. 2020. DOI: 10.1055/s-0040-1714685

[14] Functional outcomes after surgical treatment of isolated scaphotrapeziotrapezoid osteoarthritis: Retrospective single-center 24-case series. Hand Surgery and Rehabilitation. 2020. DOI: 10.1016/j.hansur.2019.11.005

[15] Traitement de l’arthrose scapho-trapezo-trapezoidïenne par implant Pyrocardan™ : résultats à 2 ans de recul minimum. Hand Surgery and Rehabilitation. 2016. DOI: 10.1016/j.hansur.2016.10.021

[16] Traitement de l’arthrose STT par un implant de resurfaçage scaphoïdien. Chirurgie de la Main. 2015. DOI: 10.1016/j.main.2015.10.063

[17] Arthroscopic Resection of Distal Pole of the Scaphoid for Scaphotrapeziotrapezoid Joint Arthritis: Comparison between Simple Resection and Implant Interposition. Journal of Wrist Surgery. 2016. DOI: 10.1055/s-0036-1572539

[19] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Evaluation, Clinical Examination, and Imaging > Evaluation and Clinical Examination: Current Concepts.

[20] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > Image DISORDERS OF THE MUSCULATURE OF THE HAND.

[21] Exam Of The Hand Wrist 2Ed. 1.1 SKELETON OF THE HAND > The osseous skeleton.

[24] Green S Operative Hand Surgery. Interosseous and Hypothenar Muscles.

[27] Exam Of The Hand Wrist 2Ed. The arches of the hand > The metacarpal arch.

[28] Exam Of The Hand Wrist 2Ed. Techniques of investigation of the arterial supply by J P Melki > Vascularization of the thumb > Palmar aspect.

[29] Campbell S Operative Orthopaedics 4 Volume Set. RESULTS OF SUTURE OF THE SCIATIC NERVE > PALMAR INCISIONS.

[31] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > FLEXOR TENDON INJURY.

[32] Exam Of The Hand Wrist 2Ed. 1.3 MOVEMENTS OF THE HAND AND WRIST > Gliding mechanisms.

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a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.