Pyrocarbon implants for the basal thumb arthritis.

Silicone implants for the treatment of basal thumb arthritis were first proposed in the 1970's by Swanson. They became extremely popular and despite good functional results, the high rate of complications such as instability, material breakage and foreign body reactions led to them being progressively abandoned by most surgeons. Pyrocarbon implants were introduced at the beginning of the 2000's. A large range of different implant models that can be used for either hemiarthroplasty or interposition arthroplasty. For some implants, a supplemental ligamentoplasty procedure is required to avoid instability. Miniaturization of some implants provides new options for minimally invasive surgery, which is relevant in low and medium grades of osteoarthritis, especially for young, active patients. Medium- and long-term follow-up have now been reached by some pyrocarbon interpositions. Their results confirm that these implants are a reliable alternative to other techniques. This paper focuses on the surgical techniques and outcomes of pyrocarbon implants for the treatment of basal thumb arthritis. It is based on published data and the author's experience.