Authors' objectives:

This review aims: 1) To identify the subset of patients who might benefit from the pyrocarbon finger joint implants 2) To compare the effectiveness and safety of the pyrocarbon finger joint implants with that of the most commonly used implants for metacarpophalangeal (MCP) and interphalangeal (PIP) joint arthroplasty.

Authors' recommendations: The following factors are important considerations in patient selection: - The condition of associated soft tissues and ligaments - The activity level of the patient - The age of the patient Pyrocarbon can be considered for patients in whom soft tissues, capsules, and the collateral ligaments as the primary movers of the finger joints are better preserved. Therefore, it is indicated for young patients with post-traumatic arthritis or osteoarthritis (OA). Patients with severe rheumatoid arthritis (RA), in which adjacent ligaments and soft tissues are badly damaged, are not good candidates for pyrocarbon finger joint implants for the restoration of function. Silicone finger joint implants are not suitable for patients who are at risk of implant fracture due to high-demand loading conditions and frequent hand movements. For young patients, an implant made of a highly durable and resistant material such as pyrocarbon is expected to reduce the rate of implant fracture. The current evidence does not support the use of pyrocarbon finger joint implants for older patients and patients with severe RA. In these patients, silicone arthroplasty can be a final salvage procedure.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2004

URL for published report: http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_pyrocarb_030104.pdf

URL for additional information: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ohtas-reports-and-ohtac-recommendations/pyrocarbon-finger-joint-implants

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Medical Advisory Secretariat

Contact Address: Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;

Contact Name: MASinfo.moh@ontario.ca

Contact Email: MASinfo.moh@ontario.ca

Copyright: Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care