JBJS - 2026-05-13 - Journal Article
PyroTITAN Pyrocarbon Shoulder Hemiarthroplasty: Clinical and Radiographic Outcomes with Medium-Term Follow-up.
Hoy G, Burrows K, McBride A, Ross M, Davis K, Warby S
Topics
Key Takeaway
PyroTITAN pyrocarbon hemiarthroplasty achieved 97.5% five-year implant survival with significant improvement in WOOS and ASES scores at all time points in patients with glenohumeral arthritis (mean age 56.5 years).
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Summary
This study evaluated clinical and radiographic outcomes of PyroTITAN pyrocarbon hemiarthroplasty in 119 shoulders with glenohumeral arthritis, using WOOS and ASES as primary PROMs with intention-to-treat analysis. Significant improvement in all PROMs and ROM was demonstrated at every postoperative time point through 5 years, with abduction strength improving significantly by 24 months. Five-year implant survival was 97.5% with only 3 revisions; glenoid erosion increased slightly but did not reach statistical significance.
Key Limitation
Absence of a control or comparator arm means it is impossible to determine whether outcomes are superior, equivalent, or inferior to anatomic TSA or conventional stemmed hemiarthroplasty in the same patient population.
Original Abstract
BACKGROUND
Pyrocarbon hemiarthroplasty (HA) is a recent option for younger patients with end-stage glenohumeral joint (GHJ) arthritis. Early results are promising but limited by study bias. The aim of this study was to evaluate medium-term clinical and radiographic outcomes following PyroTITAN pyrocarbon HA.
METHODS
One hundred and nineteen shoulders with GHJ arthritis in 115 patients (mean age, 56.5 years; 92 shoulders were in male patients) underwent PyroTITAN pyrocarbon HA. Primary patient-reported outcome measures (PROMs) included the Western Ontario Osteoarthritis of the Shoulder Index and American Shoulder and Elbow Surgeons score. Clinicians assessed shoulder range of motion and abduction strength. PROMs and clinician evaluations were recorded preoperatively and at 6, 12, and 24 months and 5 years postoperatively. Postoperative complications were recorded, and radiographs were evaluated for glenoid erosion. Implant survival was calculated over the 5-year follow-up period. Data were analyzed on an intention-to-treat basis using linear mixed models for continuous data and Friedman analysis of variance for ordinal data. Kaplan-Meier analysis assessed revision-free survival. Significance was set at p < 0.05.
RESULTS
There was significant improvement in all PROMs and ranges of motion at 6, 12, and 24 months and 5 years postoperatively. Abduction strength was significantly improved at 24 months. Seven complications (5.9%) were recorded: ongoing pain (n = 2), stiffness (n = 2), pain and stiffness (n = 2), and implant fracture (n = 1). There were 3 revisions (2.5%) and thus a 97.5% five-year survival rate. Glenoid erosion increased slightly but not significantly over time.
CONCLUSIONS
The findings in our patient series support the PyroTITAN HA implant as a viable option for GHJ arthritis across a broad age range, including younger patients.
LEVEL OF EVIDENCE
Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.