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碳素植入关节成形术

PDF Evidence Consent
Updated Oct 2026
图示：在患有关节炎的指关节或拇指关节中植入的碳素植入物。
用于覆盖关节炎关节的碳素植入物。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生，会从适合您病情的微创方案开始。患者通常由全科医生转诊至我们的诊所；如果物理治疗师建议您就诊，您仍需获得全科医生的转诊，才有资格享受 Medicare 报销。就诊时，我们会采集病史，检查您的手部，并在需要时安排影像学检查以确诊。

此手术用一块光滑、经过塑形的碳素植入物替换小关节磨损的表面。通常在长期关节炎经改变活动方式、手部治疗或支具固定后仍未缓解时，才会建议进行此手术。我们通常先尝试非手术治疗，在其改善不足时再考虑手术。对于某些结构性问题，可能会建议直接进行手术。

手术的目的是缓解疼痛，同时保持关节活动。手术还旨在保持拇指的自然高度，并保留捏力和握力。对于拇指基底关节，91%的植入物在中期随访时仍然效果良好。我们会与您详细讨论这一方案，并共同决定它是否适合您的手部情况和您的目标。

手术前

在手术前七小时内，请勿进食或饮水。我们要求七小时而非六小时，以便在手术排程提前时能够提前进行您的手术。您的外科医生会告诉您哪些常规药物需要停用以及何时停用，携带一份您所服用的全部药物的书面清单会有所帮助。请安排他人驾车送您回家，并穿着宽松舒适的衣物。通常只需X光检查即可规划手术，但有时也会使用磁共振成像（MRI）或超声检查。如果您有其他基础疾病，可能需要进行血液检查或由麻醉医生（负责实施麻醉的医生）进行评估。大多数患者两者都不需要。

手术当天

您将抵达医院的手术入院单元，在那里办理入院手续并做术前准备。您将与麻醉医生（负责您麻醉的医生）见面。该手术在全身麻醉下进行。手术期间您将处于完全睡眠状态。部分患者可能还会接受区域神经阻滞以缓解术后疼痛；麻醉医生将根据您的具体情况在当天做出决定。

随后，您将被带入手术室进行手术。术后您将在复苏区醒来，护士会在此监护您，直至麻醉作用消退。一旦您的状况稳定，根据手术类型及您的恢复情况，您将被转入病房或直接回家。

手术内容

您的外科医生将在手部需要手术的部位上方做一个切口。通过这个开口，医生会移除关节磨损、受损的表面。在磨损表面的位置，医生会放入一块光滑、经过塑形的碳素植入物，使其位于骨骼之间。这个间隔物取代了磨损关节面的作用，使骨骼能够顺畅滑动，而不再相互摩擦。

对于手掌根部的拇指关节，您的外科医生会将间隔物放置在骨骼之间，以保持拇指的自然高度。随后修复并支撑关节，使其在良好的位置上愈合。愈合期间，您的拇指可能会被固定在伸直的位置。

切口用缝线闭合。伤口上覆盖敷料，我们的团队会告诉您在最初几天如何护理伤口。

术后

大多数患者在此手术后需在医院过夜，但部分患者可能当天即可出院。您将在复苏区醒来，然后转入病房。护士会让您保持舒适，并在您需要时给您止痛药。您的手部将覆盖敷料并佩戴夹板，以在愈合期间保护手术部位。一旦您感觉站得稳，就可以下床走动。请安排人在您回家后的最初24小时内陪伴您。敷料通常保留约10天；除非我们告知您，否则请勿在此之前拆除。我们将在复诊时为您更换或拆除敷料。

恢复

在最初几天和几周内，您的手部会出现一些疼痛和肿胀。这是愈合过程中的正常现象，会逐渐缓解。休息时将手抬高会有所帮助，我们给您的止痛药也会减轻不适。大多数人发现最严重的疼痛在早期就会过去，此后舒适度会稳步改善。

您的手部将覆盖敷料并佩戴夹板，以在愈合期间保护关节。敷料保留约10天，我们将在复诊时为您更换或拆除敷料。手部手术后的康复是手部治疗，而不是物理治疗。术后您将在 Extend Rehabilitation 接受 Ruby Doolan 的手部治疗。Ruby 是一名手部治疗师：在您的手部恢复期间，她会指导您进行锻炼，并制作您所需的任何夹板。早期的锻炼较为轻柔，重点是减轻肿胀。随着活动度恢复，锻炼会逐步加强，以恢复弯曲、伸直和握力。

在夹板允许的范围内，您可以完成家中的轻松日常事务。在手部被固定期间，您不能用手术侧的手抓握、捏取或提举物品。夹板拆除且外科医生确认许可后，您可以开始更正常地使用这只手，随后即可恢复驾驶。详情请参阅我们关于上肢手术后驾驶的页面。

每个人的恢复情况各不相同。您的时间线可能有所不同，您的外科医生和治疗师会在整个过程中为您提供指导。

可能出现的问题

大多数患者恢复良好，但偶尔也会出现并发症。您的外科医生和医疗团队会密切监测您的状况，以便尽早发现任何问题。

有时植入物会移位或下沉进入骨骼。您可能会注意到关节出现新的疼痛、感觉手指或拇指没有摆正，或者其活动方式发生改变。如果您注意到其中任何一种情况，请在下次复诊时提出。

植入物也可能松动。这通常表现为在好转一段较长时间后疼痛复发，抓握或捏取时往往更明显。如果出现这种情况，请告诉您的外科医生。

关节可能会变得僵硬。手指或拇指可能无法像以前那样充分弯曲或伸直，关节背侧的肌腱也可能被瘢痕组织粘连。请在复诊时提出，以便您的治疗师调整您的锻炼。

关节可能变得不稳定，或原有的畸形可能复发。您可能会看到手指再次偏离正常排列。请在下次预约时提出。

感染并不常见，但需要及时处理。如果您出现发热、伤口周围红肿扩散，或伤口有液体或脓液渗出，请当天致电诊所。如果尽管服用了止痛药，疼痛仍持续加重，也请当天致电诊所。

在此类手术中，邻近结构可能会受到刺激或损伤。拇指附近的一条神经可能变得敏感，导致皮肤刺痛或感觉异常。腕部拇指侧的动脉或腕部前侧的一条肌腱可能会受到影响。神经阻滞在约24小时后消退，届时如果您的手指仍然麻木或无法活动，请致电诊所。神经阻滞后最初24小时内出现麻木和无力是预料之中的。

手部的骨骼偶尔会在手术中或术后发生骨折。这会引起突发疼痛和肿胀。如果出现这种情况，请致电诊所。

如果植入物失效且无法挽救，其他手术可以提供帮助。可以取出植入物并以其他方式处理该关节，这能可靠地缓解疼痛。在极少数情况下，可以将关节融合（即使其永久僵硬），或者可能需要切除该手指。

如果您想了解具体数据，本页面中的并发症表格列出了典型的发生率。

何时联系我们

大多数问题会在早期出现，及时处理会让问题更容易解决。如果您出现发热、伤口周围红肿扩散，或伤口有液体或脓液渗出，请当天致电诊所。如果尽管服用了止痛药，疼痛仍持续加重，也请当天致电诊所。神经阻滞在约24小时后消退，届时如果您的手指仍然麻木或无法活动，请致电诊所。神经阻滞后最初24小时内出现麻木和无力是预料之中的。

如果您出现小腿肿胀或疼痛，或呼吸急促或胸痛，请前往急诊科。这些可能是血栓的征兆。如果您的手指、手或拇指变得苍白、冰冷、发白、发青或发黑，请前往急诊科。这可能是血液循环问题。

如果您在非工作时间或周末无法联系到诊所，请前往离您最近的急诊科。

关于该疾病的更多阅读

本页主要介绍手术本身。关于该手术所治疗的疾病，包括证据显示手术在何时有效、何时无效，在拇指基底关节炎页面上有更详细的介绍。

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction with good implant longevity in a study with minimum 8-year follow-up [1].
  • Partial trapeziectomy with pyrocarbon arthroplasty may prove to be a successful option for the treatment of trapeziometacarpal joint osteoarthritis, providing excellent pain relief and high patient satisfaction [2].
  • PyroCarbon implant hemiarthroplasty is a promising surgical technique for stages II and III trapeziometacarpal arthritis and can provide a stable, mobile, and pain-free joint [3].
  • The Pyrocardan implant is not superior to other arthroplasty methods and has a high complication rate [4].
  • The Pyrocardan implant appears as a simple alternative to the Dubert procedure for ulnar carpo-metacarpal osteoarthritis, particularly in cases involving the 4th ray [5].
  • The PyroDisk implant for treating advanced trapeziometacarpal arthritis did not demonstrate superiority over published outcome data of trapeziectomy with or without ligament reconstruction and tendon interposition [6].
  • The good functional and radiographic outcomes, and the absence of surgical complications are evidence that the Pyrocardan resurfacing implant is a valid option for treating STT osteoarthritis [7].
  • Arthroplasty is recommended for patients with post-trauma painful PIP joints [8].
  • Active patients, under 65 years of age with Eaton-Littler stage III osteoarthritis of the thumb CMC joint who are treated with anatomic pyrolytic carbon resurfacing hemiarthroplasty and stabilisation may achieve sustained improvement in pain and hand function for up to 6.5 years [9].
  • The insertion of pyrolytic carbon implants for PIPJ arthroplasty is a technically demanding procedure, but it has the potential to achieve pain relief, stability, satisfactory ROM, and correction of the deformity [10].
  • The results of pyrolytic carbon PIPJ arthroplasty in review were unpredictable and may not be superior to those achieved with other methods of arthroplasty [10].
  • A study with long-term follow-up after pyrocarbon disc interposition for the treatment of CMC1 osteoarthritis grade 2 to 3 in more than 150 thumbs was conducted [11].
  • The PyroDisk interposition arthroplasty confirmed good 5-year clinical results [12, 13].
  • PyroDisk interposition has merit in patients with early disease unresponsive to conservative measures, in whom trapeziectomy may be considered too destructive and hemi or total arthroplasty overzealous [14].
  • The good results, the simple surgical procedure, the absence of complications, and the lack of a need for any fixation or ligamentoplasty confirm the advantages of this pyrocarbon implant in the treatment of STT arthrosis [15].
  • All subjective and objective outcomes were similar following LRTI and pyrolytic interpositional arthroplasty in patients with TMC arthritis, except pinch strength, which was more improved following pyrolytic interpositional arthroplasty [16].
  • The encouraging mid-term clinical results of the interposition implant (APSI) in the context of proximal pole scaphoid pseudarthrosis make this technique a proven alternative, without precluding a definitive therapeutic option in case of failure [18].
  • 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 [20].

Anatomy & Pathophysiology

Bony Anatomy

  • The skeleton of the hand and wrist consists of 27 bones, of which 19 are long bones [28].
  • The radial ray or first ray is the shortest, made up of only three bones: a metacarpal and two phalanges [28].
  • The trapezium is clearly angled out in front of the carpal plane so that the first metacarpal makes an angle of about 45 degrees with the second metacarpal in the sagittal plane [28].
  • The thumb metacarpal is the shortest, while the index metacarpal is by far the longest [28].
  • The epiphyseal plates are located at the proximal ends of the phalanges and the first metacarpal, whereas they are located at the distal ends of the other metacarpals [28].
  • The thumb metacarpal is independent and articulates with the trapezium [35].
  • The index metacarpal is the most firmly fixed [35].
  • The ring metacarpal has about 10 degrees of mobility in flexion and extension [35].
  • The fifth metacarpal has a range of flexion–extension of approximately 20 degrees [35].

Soft Tissue & Vascular Anatomy

  • The extrinsic extensors run through six different fibroosseous retinacular compartments at the wrist level [27].
  • The first (most radial) compartment contains the abductor pollicis longus and the extensor pollicis brevis [27].
  • The second extensor compartment contains the extensor carpi radialis longus and the extensor carpi radialis brevis [27].
  • The third compartment contains the extensor pollicis longus, which turns abruptly radialward about Lister tubercle [27].
  • The fourth extensor compartment contains the extensor indicis proprius lying deep to the four tendons of the extensor digitorum communis [27].
  • The fifth compartment contains the extensor digiti quinti [27].
  • The sixth compartment contains the extensor carpi ulnaris tendon, which inserts at the base of the little finger metacarpal [27].
  • The extrinsic finger flexors are the flexor digitorum profundus and the flexor digitorum superficialis [27].
  • The flexor digitorum profundus inserts on the proximal volar aspect of the distal phalanx [27].
  • The flexor digitorum superficialis acts as a flexor of the proximal interphalangeal and metacarpophalangeal joints [27].
  • There are seven interosseous muscles, four dorsal and three volar [32].
  • The dorsal interossei are abductors [32].
  • The volar interossei are adductors [32].
  • The middle finger has two dorsal interossei (abductors) and no volar interossei (adductors) because the central axis of the hand lies within it [32].
  • The "princeps pollicis" artery is the terminal branch of the radial artery and crosses the first intermetacarpal space [36].
  • The princeps pollicis runs along the ulnar side of the first metacarpal bone and along the volar surface of the adductor muscle [36].
  • The princeps pollicis divides into two terminal rami, namely the collateral palmar arteries of the thumb, at the level of the cutaneous flexion crease of the metacarpophalangeal joint [36].
  • An arcade located deep in the flexor tendon joins together the two arteries at the level of the distal metaphysis of the first phalanx [36].
  • The dorsal arteries of the thumb originate from the palmar arteries (princeps, commissural or anastomoses of the superficial arcade) at the level of the first metacarpal [36].

Functional Mechanics

  • The wrist has three axes of movement, permitting the hand to be positioned in any spatial configuration [28].
  • The thumb ray is more mobile, shorter, and more proximal than the other rays, allowing it to project in front of the plane of the palm to oppose itself to the other four rays [28].
  • The skeleton of the hand presents a longitudinal and transverse concavity, giving it the shape of a cup with a palmar concavity when the thumb is placed next to the index finger [28].
  • The transverse axis of the palm forms an acute angle of approximately 75 degrees with the longitudinal axis [28].
  • The metacarpal arch is endowed with a great deal of adaptability because of the mobility of the peripheral metacarpals [35].
  • The heads of the second and third metacarpals are fixed [35].
  • The mobility of the ulnar metacarpals allows "flexion" of 10 degrees for the fourth metacarpal, and "flexion" of 20 degrees for the fifth metacarpal [35].
  • The keystones of the longitudinal arches are the metacarpophalangeal articulations, whose thick anterior glenoid capsules, the volar plates, prevent hyperextension [35].
  • The dorsal skin slides distally to allow metacarpophalangeal joint flexion [40].
  • Interphalangeal flexion is accomplished by means of a special arrangement of skin folds on the dorsum of each articulation [40].
  • The gliding mechanism for tendons in narrow crowded areas is assured by the synovial sheath, which allows a considerable amplitude of movement [40].
  • The fibrous sheath assumes the role of a pulley when the tendon changes direction [40].
  • The position of each articulation depends on the equilibrium of forces acting at that level, and this equilibrium is subject to the position of the immediately proximal articulation [40].
  • Single articular movements around a fixed perpendicular axis simply do not exist in the hand [40].
  • Almost all movements in the hand are around oblique and variable axes, resulting in combined movements permitting optimal orientation of the phalanges at the time of prehension [40].

Indications and Disease Staging

  • PyroCarbon implant hemiarthroplasty is a promising surgical technique for stages II and III trapeziometacarpal arthritis [3].
  • The Pyrocardan resurfacing implant is a valid option for treating scaphotrapeziotrapezoid (STT) osteoarthritis [7].
  • The pyrocarbon implant is indicated for the treatment of STT arthrosis [15].
  • The pyrocarbon interposition implant (APSI) is an alternative for the treatment of proximal pole scaphoid pseudarthrosis [18].
  • 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 [20].

Patient Selection and Demographics

  • Active patients under 65 years of age with Eaton-Littler stage III osteoarthritis of the thumb CMC joint are candidates for anatomic pyrolytic carbon resurfacing hemiarthroplasty and stabilisation [9].
  • Pyrocarbon disc interposition is used for the treatment of CMC1 osteoarthritis grade 2 to 3 [11].
  • Total trapezectomy associated with the placement of a NuGrip pyrocarbon implant is a procedure for the replacement of the TMC joint [22].

Comparative Classification and Efficacy

  • The insertion of pyrolytic carbon implants for PIPJ arthroplasty has the potential to achieve pain relief, stability, satisfactory ROM, and correction of the deformity; however, the results in this review were unpredictable and may not be superior to those achieved with other methods of arthroplasty [10].

Clinical Presentation

  • Pyrocarbon interpositional arthroplasty is indicated for trapeziometacarpal osteoarthritis [1].
  • Pyrocarbon interpositional arthroplasty is indicated for trapeziometacarpal joint osteoarthritis [2].
  • PyroCarbon implant hemiarthroplasty is a surgical technique for stages II and III trapeziometacarpal arthritis [3].
  • The Pyrocardan implant is used for trapeziometacarpal osteoarthritis [4].
  • The Pyrocardan implant is used for ulnar carpo-metacarpal osteoarthritis, particularly in cases involving the 4th ray [5].
  • The PyroDisk implant is used for advanced trapeziometacarpal arthritis [6].
  • The Pyrocardan resurfacing implant is used for scaphotrapeziotrapezoid (STT) osteoarthritis [7].
  • Pyrocarbon PIP arthroplasty is used for post-trauma painful joints [8].
  • Anatomic pyrolytic carbon resurfacing hemiarthroplasty is used for Eaton-Littler stage III osteoarthritis of the thumb CMC joint in patients under 65 years of age [9].
  • Pyrolytic carbon implants are used for proximal interphalangeal joint (PIPJ) arthroplasty [10].
  • Pyrocarbon disc interposition is used for CMC1 osteoarthritis grade 2 to 3 [11].
  • PyroDisk interposition arthroplasty is used for trapeziometacarpal osteoarthritis [12].
  • PyroDisk interposition is indicated for patients with early disease unresponsive to conservative measures, in whom trapeziectomy may be considered too destructive and hemi or total arthroplasty overzealous [14].
  • The pyrocarbon implant is used for STT arthrosis [15].
  • Pyrolytic interpositional arthroplasty is used for TMC arthritis [16].
  • Pi2 pyrocarbon spacer arthroplasty is used for carpometacarpal joint osteoarthritis [17].
  • The interposition implant (APSI) is used for pseudarthrosis of the proximal pole of the scaphoid [18].
  • A pyrocarbon implant is used for Kienböck disease [19].
  • Total trapeziectomy associated with the placement of a pyrocarbon type Nugrip implant is used after replacement of the TMC joint [22].
  • The Pyrocardan implant is used for stage 2 trapeziometacarpal osteoarthritis [23].
  • The Pi2 pyrocarbon implant is used in total trapeziectomy and suspension ligamentoplasty [24].
  • The Pi2 pyrocarbon implant is used in destructions of the capitolunate joint space [25].

Investigations

  • Clinical evaluation of the hand and wrist requires combining patient history with a careful physical examination to pinpoint or narrow the scope of possible pathologic processes [26].
  • Diagnostic tests such as imaging and serum laboratory studies are useful in determining hand pathology but can be expensive, time-consuming, and often nonspecific [26].
  • A systematic method to approaching the physical examination of the hand is essential due to the number of structures in a small space [26].

Treatment

Trapeziometacarpal Joint Osteoarthritis

  • Pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction with good implant longevity in a minimum 8-year follow-up study [1].
  • Partial trapeziectomy with pyrocarbon arthroplasty provides excellent pain relief and high patient satisfaction for trapeziometacarpal joint osteoarthritis [2].
  • PyroCarbon implant hemiarthroplasty is a promising surgical technique for stages II and III trapeziometacarpal arthritis that can provide a stable, mobile, and pain-free joint [3].
  • The Pyrocardan implant is not superior to other arthroplasty methods and has a high complication rate for trapeziometacarpal osteoarthritis [4].
  • Long-term follow-up data for pyrocarbon disc interposition for the treatment of CMC1 osteoarthritis grade 2 to 3 is available in a study involving more than 150 thumbs [11].
  • Interposition arthroplasty with PyroDisk confirmed good 5-year clinical results [12, 13].
  • The modified procedure of partial trapeziectomy and pyrocarbon interpositional arthroplasty improves functional results by increasing active and passive range of movement at the TMCJ, providing joint stability and pain relief comparable to standard techniques, while preserving thumb length and key pinch strength [29].
  • Pyrocarbon interposition arthroplasty for trapeziometacarpal osteoarthritis does not preclude subsequent conventional arthroplasty techniques in the event of failure [23].

Scaphotrapeziotrapezoid Joint Osteoarthritis

  • The Pyrocardan resurfacing implant is a valid option for treating STT osteoarthritis, evidenced by good functional and radiographic outcomes and the absence of surgical complications [7].
  • The good results, simple surgical procedure, absence of complications, and lack of need for fixation or ligamentoplasty confirm the advantages of the pyrocarbon implant in the treatment of STT arthrosis [15].

Other Indications

  • Pyrocarbon PIP arthroplasty is recommended for post-trauma painful joints [8].
  • The insertion of pyrolytic carbon implants for PIPJ arthroplasty is a technically demanding procedure with the potential to achieve pain relief, stability, satisfactory ROM, and correction of deformity, though results were unpredictable and may not be superior to other methods of arthroplasty [10].
  • Range of motion improved after Pi2 pyrocarbon spacer arthroplasty in carpometacarpal joint osteoarthritis, especially in opposition with a mean Kapandji score of 9.60, with no major aggravation of metacarpophalangeal extension [17].
  • The interposition implant (APSI) for proximal scaphoid pseudarthrosis provides encouraging mid-term clinical results and serves as a proven alternative without precluding a definitive therapeutic option in case of failure [18].
  • There were no changes in range of motion after surgery for Kienböck disease treated with a pyrocarbon implant, and the average grip strength was 76.5% of the contralateral side [19].

Complications

  • The Pyrocardan implant has a high complication rate [4].
  • The Pyrocardan resurfacing implant for STT osteoarthritis was associated with the absence of surgical complications [7].
  • The pyrocarbon implant for STT arthrosis was associated with the absence of complications [15].

Recovery

  • Range of motion improved after Pi2 pyrocarbon spacer arthroplasty, especially in opposition, with a mean Kapandji score of 9.60 [17].
  • There was no major aggravation of metacarpophalangeal extension following Pi2 pyrocarbon spacer arthroplasty [17].
  • The average grip strength was 76.5% of the contralateral side after pyrocarbon implant treatment for Kienböck disease [19].
  • There were no changes in range of motion after surgery for Kienböck disease treated with a pyrocarbon implant [19].

Key Evidence

  • [L4] Pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction with good implant longevity. [1] (10.1177/1753193420906805)
  • [L3] Partial trapeziectomy with pyrocarbon arthroplasty may prove to be a successful option for the treatment of trapeziometacarpal joint osteoarthritis, providing excellent pain relief and high patient satisfaction. [2] (10.1177/1753193413519384)
  • [L4] PyroCarbon implant hemiarthroplasty is a promising surgical technique for stages II and III trapeziometacarpal arthritis and can provide a stable, mobile, and pain-free joint. [3] (10.1097/bth.0b013e318271aab7)
  • [L4] The study concludes that the Pyrocardan implant is not superior to other arthroplasty methods and has a high complication rate. [4] (10.1016/j.hansur.2016.09.004)
  • [L4] The Pyrocardan implant appears as a simple alternative to the Dubert procedure for ulnar carpo-metacarpal osteoarthritis, particularly in cases involving the 4th ray. [5] (10.1016/j.hansur.2018.10.044)
  • [L4] The PyroDisk implant for treating advanced trapeziometacarpal arthritis did not demonstrate superiority over published outcome data of trapeziectomy with or without ligament reconstruction and tendon interposition. [6] (10.1016/j.jhsa.2014.07.011)
  • [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. [7] (10.1016/j.hansur.2017.01.003)
  • [L4] We recommend arthroplasty for this group of patients. [8] (10.1016/s0363-5023(03)80384-2)
  • [L3] Active patients, under 65 years of age with Eaton-Littler stage III osteoarthritis of the thumb CMC joint who are treated with anatomic pyrolytic carbon resurfacing hemiarthroplasty and stabilisation may achieve sustained improvement in pain and hand function for up to 6.5 years. [9] (10.1142/s2424835518500443)
  • [L4] The insertion of pyrolytic carbon implants for PIPJ arthroplasty is a technically demanding procedure, but it has the potential to achieve pain relief, stability, satisfactory ROM, and correction of the deformity; however, the results in this review were unpredictable and may not be superior to those achieved with other methods of arthroplasty. [10] (10.1016/j.jhsa.2006.02.018)
  • [L4] This is the first study with long-term follow-up after pyrocarbon disc interposition for the treatment of CMC1 osteoarthritis grade 2 to 3 in more than 150 thumbs. [11] (10.1016/j.jhsa.2018.06.086)
  • [L4] Our study confirms the good 5-year clinical results of interposition arthroplasty with PyroDisk. [12] (10.1177/1558944716660555n)
  • [L4] Our study confirms the good 5-year clinical results of interposition arthroplasty with PyroDisk. [13] (10.1177/1558944716660555m)
  • [L4] PyroDisk interposition has merit in patients with early disease unresponsive to conservative measures, in whom trapeziectomy may be considered too destructive and hemi or total arthroplasty overzealous. [14] (10.1177/1753193420981552)
  • [L4] The good results, the simple surgical procedure, the absence of complications, and the lack of a need for any fixation or ligamentoplasty confirm the advantages of this pyrocarbon implant in the treatment of STT arthrosis. [15] (10.1016/j.main.2005.04.010)
  • [L3] All subjective and objective outcomes were similar following LRTI and pyrolytic interpositional arthroplasty in patients with TMC arthritis, except pinch strength, which was more improved following pyrolytic interpositional arthroplasty. [16] (10.1155/2019/7961507)
  • [L3] Range of motion improved, especially in opposition (mean Kapandji score, 9.60), with no major aggravation of metacarpophalangeal extension. [17] (10.1016/j.hansur.2016.05.002)
  • [L4] Les résultats cliniques encourageants à moyen terme de l’implant d’interposition (APSI), dans le cadre d’une pseudarthrose du pôle proximal du scaphoïde, font de cette technique une alternative probante, sans interdire une option thérapeutique définitive en cas d’échec. [18] (10.1016/j.main.2011.10.031)
  • [L5] There were no changes in range of motion after surgery and the average grip strength was 76.5% of the contralateral side. [19] (10.1016/j.main.2014.09.002)
  • [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. [20] (10.1016/j.jhsg.2026.100964)
  • [L4] La trapézectomie totale associée à la mise en place d'un implant en pyrocarbone type Nugrip après le remplacement de l'articulation TMC semble être une procédure attrayante. [22] (10.1016/j.hansur.2018.10.166)
  • [L3] Il ne coupe pas les ponts en cas d'éventuel échec à des techniques d'arthroplastie plus conventionnelles. [23] (10.1016/j.main.2011.10.132)
  • [L3] The implant Pi2 seems to contribute keeping trapezial height, without functional advantages and with a risk of dislocation. [24] (10.1016/j.main.2013.04.003)
  • [L4] Cette technique a l'avantage de préserver les mobilités médio-carpiennes et les ligaments extrinsèques du poignet. [25] (10.1016/j.hansur.2016.10.125)
  • [L4] The modified procedure improves functional results by increasing active and passive range of movement at the TMCJ, providing joint stability and pain relief comparable to standard techniques, while preserving thumb length and key pinch strength. [29] (10.1177/1753193414553368)

References

[1] Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420906805

[2] Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193413519384

[3] PyroCarbon Implant Hemiarthroplasty for Trapeziometacarpal Arthritis. Techniques in Hand & Upper Extremity Surgery. 2013. DOI: 10.1097/bth.0b013e318271aab7

[4] Early outcomes of Pyrocardan® implants for trapeziometacarpal osteoarthritis. Hand Surgery and Rehabilitation. 2016. DOI: 10.1016/j.hansur.2016.09.004

[5] L’implant en Pyrocarbone (Pyrocardan®) dans le traitement de l’arthrose carpo-métacarpienne ulnaire post-traumatique. Hand Surgery and Rehabilitation. 2018. DOI: 10.1016/j.hansur.2018.10.044

[6] Pyrocarbon Interposition (PyroDisk) Implant for Trapeziometacarpal Osteoarthritis: Minimum 5-Year Follow-Up. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.07.011

[7] 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

[8] Pyrocarbon PIP arthroplasty for post trauma painful joints. The Journal of Hand Surgery. 2003. DOI: 10.1016/s0363-5023(03)80384-2

[9] Anatomic Pyrocarbon Hemiarthroplasty for Thumb Carpometacarpal Osteoarthritis in Patients under 65 Years: Mid Term Results. The Journal of Hand Surgery (Asian-Pacific Volume). 2018. DOI: 10.1142/s2424835518500443

[10] Pyrolytic Carbon Proximal Interphalangeal Joint Resurfacing Arthroplasty. The Journal of Hand Surgery. 2006. DOI: 10.1016/j.jhsa.2006.02.018

[11] Long-Term Follow-Up After Pyrocarbon Disc Interposition for Thumb CMC Osteoarthritis. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.06.086

[12] Pyrocarbon Interposition Arthroplasty of the Trapeziometacarpal Joint With the PyroDisk. HAND. 2016. DOI: 10.1177/1558944716660555n

[13] PyroDisk Interposition Implant for Trapeziometacarpal Osteoarthritis. HAND. 2016. DOI: 10.1177/1558944716660555m

[14] Re: Smeraglia F, et al. Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up. J Hand Surg Eur. 2020, 45: 472–6. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/1753193420981552

[15] Traitement de l'arthrose S.T.T. par un Implant en pyrocarbone. Premiers résultats. Chirurgie de la Main. 2005. DOI: 10.1016/j.main.2005.04.010

[16] Tendon versus Pyrocarbon Interpositional Arthroplasty in the Treatment of Trapeziometacarpal Osteoarthritis. BioMed Research International. 2019. DOI: 10.1155/2019/7961507

[17] A ten-year prospective outcome study of Pi2 pyrocarbon spacer arthroplasty in carpometacarpal joint osteoarthritis. Hand Surgery and Rehabilitation. 2016. DOI: 10.1016/j.hansur.2016.05.002

[18] Pseudarthrose du scaphoïde : résection proximale et interposition d’un implant en pyrocarbone, à propos de 20 cas. Chirurgie de la Main. 2011. DOI: 10.1016/j.main.2011.10.031

[19] Le traitement de la maladie de Kienböck par un implant en pyrocarbone : fait clinique. Chirurgie de la Main. 2014. DOI: 10.1016/j.main.2014.09.002

[20] 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

[22] Reprise de prothèses totales trapézo-métacarpiennes par un implant en Pyrocarbone type NuGrip. À propos de 6 cas. Hand Surgery and Rehabilitation. 2018. DOI: 10.1016/j.hansur.2018.10.166

[23] L’implant pyrocardan : interposition libre en pyrocarbone trapezometacarpienne pour l’arthrose de stade 2. Chirurgie de la Main. 2011. DOI: 10.1016/j.main.2011.10.132

[24] Trapézectomie totale et ligamentoplastie de suspension : une interposition par un implant Pi2® en pyrocarbone a-t-elle un intérêt ?. Chirurgie de la Main. 2013. DOI: 10.1016/j.main.2013.04.003

[25] Utilisation de l’implant en pyrocarbone de type Pi2 dans les destructions de l’interligne articulaire capito-lunaire. Hand Surgery and Rehabilitation. 2016. DOI: 10.1016/j.hansur.2016.10.125

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

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

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

[29] Re: Mariconda et al. Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal joint osteoarthritis: results after minimum 2 years of follow-up. J Hand Surg Eur. 2014, 39: 604–610. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414553368

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

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

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

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

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