BJJ - 2026-06-01 - Journal Article
The experience of stemmed pyrocarbon shoulder hemiarthroplasty in New Zealand : ten years of registry data.
Konarski AJ, Mohammed KD
Topics
Key Takeaway
Stemmed pyrocarbon shoulder hemiarthroplasty in 277 patients achieved a revision rate of 0.75 per 100 component-years at mean 50-month follow-up, with Oxford Shoulder Scores improving from 36.4 at 6 months to 40.8 at 5 years.
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Summary
This study queried the New Zealand National Joint Registry for all stemmed pyrocarbon hemiarthroplasties (PyCHA) performed between January 2014 and December 2024 to evaluate clinical outcomes and revision rates. The most common indication was OA (53.5%), with a mean patient age of 55 years. Revision rate was 0.75 per 100 component-years, OSS improved from 36.4 at 6 months to 40.8 at 5 years, and the trauma sequelae group had significantly lower 6-month OSS than OA or AVN groups (p<0.05).
Key Limitation
Glenoid erosion—the primary proposed advantage of pyrocarbon over conventional metal hemiarthroplasty—was not assessed radiographically, so the mechanism justifying implant selection over aTSA or RSA remains unconfirmed in this dataset.
Original Abstract
AIMS
Pyrocarbon has been used as a bearing surface in hemiarthroplasty (HA) of the shoulder for more than a decade. The use of pyrocarbon is thought to reduce the rate of glenoid erosion compared with metal HA, and reduce the risk of glenoid complications compared with anatomical total shoulder arthroplasty (aTSA). However, there is little information about the long-term outcomes. The aim of this study was to investigate the use of pyrocarbon HA (PyCHA) in New Zealand, and the clinical outcomes and revision rates.
METHODS
The New Zealand National Joint Registry was used to obtain data on all patients undergoing HA of the shoulder with a stemmed PyCHA. Data which were assessed included the indication for surgery, patient-reported outcome scores, and revision rates.
RESULTS
Between January 2014 and December 2024, 288 stemmed PyCHAs were recorded in 277 patients, with a mean age of 55 years (20 to 86). The mean follow-up was 50 months (3 to 128). The use increased 2.3-fold during the study period. The most common indication for surgery was osteoarthritis (OA) (154 (53.5%)), followed by avascular necrosis (AVN) (52 (18.1%)), the sequelae of trauma (48 (16.7%)) and after recurrent dislocation (38 (13.2%)). The mean Oxford Shoulder Score (OSS) was 36.4 (SD 8.2) six months postoperatively, increasing to 40.8 (SD 7.9) at five years. The revision rate was 0.75 per 100 component-years (95% CI 0.34 to 1.42). The mean six-month OSS was significantly lower in the sequelae of trauma group than in the OA (p = 0.014) or AVN groups (p = 0.020).
CONCLUSION
The use of PyCHA is increasing in New Zealand. It is typically used in younger patients with OA. It has good clinical outcomes and low revision rates at mid-term follow-up. Further study is needed to assess the ideal indications for this procedure and the long-term clinical outcomes and revision rates.