586 A Systematic Review of Outcomes Following Pyrocarbon Hemiarthroplasty of the Shoulder
W X Low, A Asokan, D Williams, N Aresti- Surgery
Abstract
Aim
Pyrocarbon (PyC) is increasingly used in shoulder hemiarthroplasty (HA) due to its favourable tribology in reducing glenoid erosion. This systematic review aims to evaluate the clinical and functional outcomes, along with the survivorship of PyC HA.
Method
PubMed (MEDLINE), Cochrane, Embase, and Google Scholar were systematically searched from inception in accordance with the PRISMA guidelines. Searched terms included ‘Pyrocarbon OR Pyrolytic Carbon’, ‘Hemiarthroplasty’, and ‘Shoulder’. Studies reporting clinical, functional outcomes, or survivorship of stemmed PyC shoulder HA were included. Quality of evidence was assessed using the MINORS criteria.
Results
Six studies met the inclusion criteria. 197 shoulders with PyC HAs were analysed at mean follow-up of 30.1±7.6 months. The Constant Score improved from 35.1±16.5 preoperatively to 74.3±15.6 at final follow-up (p<0.001). Patients with post-traumatic sequelae showed less of an improvement, from 25.4±15.4 to 50.5±20.7 (p<0.005). Subjective Shoulder Value was reported in two studies, showing an improvement from 35.0±21.9 to 81.1±12.9 (p<0.001). Statistically significant improvements in active range of motion were reported across five studies. Radiographic evidence of progressive glenoid erosion was observed in 24.6% of the shoulders, however only 1.7% were revised due to painful glenoid erosion. The overall revision rate was 7.4%.
Conclusions
The current literature suggests PyC HA provides promising clinical outcomes comparable to non-PyC alternatives. The rate of clinically significant glenoid erosion at short-term follow-up remains low. However, the paucity in the literature would benefit from larger and longer-term studies to validate the use of PyC HA over other forms of shoulder arthroplasty.