We performed a systematic review to find out the safety and efficacy of various procedures for isolated scaphotrapeziotrapezoid osteoarthritis. Eleven articles were included. The most common procedure was arthroplasty with pyrocarbon implant (28%), followed by resection of distal pole of scaphoid with proximal trapezium and trapezoid resection (18%). The other procedures included trapeziectomy with ligament reconstruction and tendon interposition (LRTI) (14%), arthroscopic resection of distal scaphoid (11%), trapezium and trapezoid resection with LRTI (10%) and arthrodesis (10%). Complications were noted in 18 (15%) patients. The most common complication (7.5%) was asymptomatic dorsal intercalated segmental instability (DISI) followed by dislocation of the pyrocarbon implant (3%). Fusion resulted in decreased range of motion and grip strength. The distal scaphoid resection was related to high rate of DISI. Although the pyrocarbon implant has a higher dislocation rate which requires revision surgery, this complication is avoidable with good surgical technique. Arthroplasty with pyrocarbon implant may be the first choice in younger patients.
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Article Synopsis
- The study aimed to create engineered cartilage using pyrocarbon (PyC) biomaterial and differentiated chondrocytes, focusing on a scaffold-free and mechanically stimulated process.
- By applying uniaxial cyclic compression in a specially designed tribo-bioreactor, the researchers aimed to keep the chondrocytes in a cartilage-like phenotype while enhancing the matrix composition.
- Findings indicated that the combination of PyC and dynamic stimulation led to denser constructs with improved mechanical properties and no signs of unwanted cell maturation, highlighting the effectiveness of integrating biomaterials with mechanical stimuli in tissue engineering.
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