Análisis funcional comparativo entre la prótesis de carbón pirolítico y la artroplastia de suspensión-reconstrucción ligamentosa para el tratamiento de la rizartrosis del pulgar / Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the treatment of rhizarthrosis

Objetivo: Evaluar el resultado funcional a medio plazo de la utilización del implante de carbón pirolítico (PyroDisk) en el tratamiento de la rizartrosis del pulgar, comparando sus resultados con la artroplastia de resección-suspensión-reconstrucción ligamentosa. Material y método: Estudio transversal que compara de forma retrospectiva 2grupos de pacientes entre 40 y 65 años con rizartrosis del pulgar. Los 32 pacientes intervenidos entre 2009 y 2013 se distribuyeron entre el grupo I (artroplastia de interposición con el implante PyroDisk y el grupo II (artroplastia de resección-suspensión-reconstrucción ligamentosa). En 2015 se recogieron el dolor, la funcionalidad (cuestionario Quick-Dash) y el balance articular. Además, se realizó un estudio radiológico con radiografías y TC. Resultados: Se siguió a 32 pacientes, 16 en cada grupo, con un seguimiento medio de 35 meses (23-47). El dolor al final del seguimiento fue mayor en el grupo intervenido con la prótesis de carbón pirolítico (p=0,000). En la funcionalidad según el test de QuickDash, los pacientes del grupo i obtuvieron una media de 31,14 (0-70) puntos frente a 15,81 (8-24) puntos del grupo ii (p=0,027). No se encontraron diferencias en el grado de movilidad al final del seguimiento (p=0,46). En 6 casos fue necesario retirar la prótesis. Discusión: La prótesis de carbón pirolítico se ha presentado como alternativa para el tratamiendo de la rizartrosis del pulgar. En los trabajos publicados hasta el momento destaca la discrepancia en los resultados funcionales a medio plazo. Conclusiones: La prótesis de carbón pirolítico ha mostrado resultados funcionales inferiores a medio plazo comparada con la artroplastia de resección-suspensión-reconstrucción ligamentosa

Objective: To evaluate midterm functional outcome after pyrolytic carbon prosthesis (PyroDisk) implantation in the treatment of rhizarthrosis of the thumb, comparing outcomes with those of ligamentous resection/suspension/reconstruction. Material and methods: A cross-sectional study retrospectively comparing 2patient groups aged between 40 and 65 years with rhizarthrosis of the thumb. Thirty-two patients operated between 2009 and 2013 were distributed between group I (interposition arthroplasy with PyroDisk implant) and group II (ligamentous resection/suspension/reconstruction arthroplasty). Data on pain, functionality (Quick-Dash questionnaire) and articular movement were collected in 2015. In addition, a radiological study was undertaken using radiographs and CT. Results: Thirty-two patients, 16 in each group with mean follow-up of 35 months (23-47). Pain at the end of follow-up was greater in the group with the pyrolytic carbon prosthesis (p=0.000). According to the QuickDash questionnaire, the patients in group i achieved a mean functionality of 31.14 (0-70) points compared to 15.81 (8-24) points for group ii (p=0.027). No differences were found in degree of mobility at the end of follow-up (p=0.46). The prosthesis had to be removed in 6 cases. Discussion: The pyrolytic carbon prosthesis has been presented as an alternative treatment for rhizarthrosis of the thumb. The papers pubslished to date highlight the discrepancies in midterm functional outcomes. Conclusions: Pyrolitic carbon prostheses have shown inferior functional outcomes, compared with resection/suspension/reconstruction arthroplasties

Comparative functional analysis between pyrolytic carbon prostheses and ligamentous suspension/reconstruction in the treatment of rhizarthrosis. / Análisis funcional comparativo entre la prótesis de carbón pirolítico y la artroplastia de suspensión-reconstrucción ligamentosa para el tratamiento de la rizartrosis del pulgar.

OBJECTIVE: To evaluate midterm functional outcome after pyrolytic carbon prosthesis (PyroDisk) implantation in the treatment of rhizarthrosis of the thumb, comparing outcomes with those of ligamentous resection/suspension/reconstruction. MATERIAL AND METHODS: A cross-sectional study retrospectively comparing 2patient groups aged between 40 and 65 years with rhizarthrosis of the thumb. Thirty-two patients operated between 2009 and 2013 were distributed between group i (interposition arthroplasy with PyroDisk implant) and group ii (ligamentous resection/suspension/reconstruction arthroplasty). Data on pain, functionality (Quick-Dash questionnaire) and articular movement were collected in 2015. In addition, a radiological study was undertaken using radiographs and CT. RESULTS: Thirty-two patients, 16 in each group with mean follow-up of 35 months (23-47). Pain at the end of follow-up was greater in the group with the pyrolytic carbon prosthesis (p=0.000). According to the QuickDash questionnaire, the patients in group i achieved a mean functionality of 31.14 (0-70) points compared to 15.81 (8-24) points for group ii (p=0.027). No differences were found in degree of mobility at the end of follow-up (p=0.46). The prosthesis had to be removed in 6 cases. DISCUSSION: The pyrolytic carbon prosthesis has been presented as an alternative treatment for rhizarthrosis of the thumb. The papers pubslished to date highlight the discrepancies in midterm functional outcomes. CONCLUSIONS: Pyrolitic carbon prostheses have shown inferior functional outcomes, compared with resection/suspension/reconstruction arthroplasties.