Early outcomes of arthroplasty of the first carpometacarpal joint using pyrocarbon spherical implants
Bibliographic record
Abstract
The first carpometacarpal joint (CMC) is the most common hand joint to develop osteoarthritis. A survey found that many hand surgeons have revisited implant arthroplasty because it preserves critical structures. However, there is currently no implant with an ideal design and material composition. The present study was the first to use and evaluate early outcomes of pyrocarbon spherical implants for arthroplasty of the first CMC in patients with Eaton-Littler stage II and III osteoarthritis. A single surgeon performed 24 arthroplasties (23 patients [20 women, three men] with a mean age of 56 years [range 46 to 75 years]) of the first CMC (nine right hands and 15 left hands) using pyrocarbon spherical implants from May 2010 to April 2013. All patients failed conservative management. At a mean (± SD) of 18.5±11.16 months postoperatively (range 4.3 to 38.9 months), the mean Kapandji score was 8.8 of 10 (range 7 to 10), the average pre- and postoperative values on the visual pain scale were 8.96±0.64 of 10 (range 8 to 10) and 1.13±1.22 of 10 (range 0 to 4), respectively. All patients were either very satisfied (score = 5) or satisfied (score = 4) with the procedure, with a mean satisfaction score of 4.76±0.44 of 5.00 (range 4 to 5). The mean postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score was 11.79±14.29 (range 0 to 49.17). The most recent radiographic evaluations confirmed that all implants were stable with no erosion of nearby cancellous bone. There were no implant subluxations, dislocations or revisions. Early outcomes show promising results and support continued use of this implant for arthroplasty. However, longer-term follow-up will be needed to confirm these results.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".