This is a 5-center case series of pyrocarbon-head hemiarthroplasty (HA-PYC) for glenohumeral osteoarthritis in patients aged ≤60. It asks whether pyrocarbon can be a middle-ground alternative to metal-head hemiarthroplasty and total shoulder arthroplasty in young, active patients. Outcomes measured were revision, function, return to work and sport, glenoid erosion, and quality of humeral reconstruction.
When you face glenohumeral OA in a patient under 60, you are stuck between two bad long-term options: metal-head hemiarthroplasty erodes the glenoid, and TSA loosens the glenoid component. This series positions pyrocarbon hemiarthroplasty as a middle path, with 92% short-term survival, strong functional gains, and high return to work and sport.
The single most actionable lesson is about head sizing. The pyrocarbon head sits on a 1.5-mm metal support disc, making it 2 mm thicker than a metal head of the same diameter. If you pick your usual size, you overstuff the joint, push the center of rotation more than 3 mm off, and drive up subscapularis failure, symptomatic erosion, and revision (22% vs 2.2%).
Two reassuring points for your mental model: glenoid erosion by Sperling grade did not affect function, and adding concentric reaming for a biconcave glenoid did not worsen outcomes. Remember this is Level IV evidence at only 33 months with no control group, so durability against TSA remains unproven.
This is a 5-center case series of pyrocarbon-head hemiarthroplasty (HA-PYC) for glenohumeral osteoarthritis in patients aged ≤60. It asks whether pyrocarbon can be a middle-ground alternative to metal-head hemiarthroplasty and total shoulder arthroplasty in young, active patients. Outcomes measured were revision, function, return to work and sport, glenoid erosion, and quality of humeral reconstruction.
When you face glenohumeral OA in a patient under 60, you are stuck between two bad long-term options: metal-head hemiarthroplasty erodes the glenoid, and TSA loosens the glenoid component. This series positions pyrocarbon hemiarthroplasty as a middle path, with 92% short-term survival, strong functional gains, and high return to work and sport.
The single most actionable lesson is about head sizing. The pyrocarbon head sits on a 1.5-mm metal support disc, making it 2 mm thicker than a metal head of the same diameter. If you pick your usual size, you overstuff the joint, push the center of rotation more than 3 mm off, and drive up subscapularis failure, symptomatic erosion, and revision (22% vs 2.2%).
Two reassuring points for your mental model: glenoid erosion by Sperling grade did not affect function, and adding concentric reaming for a biconcave glenoid did not worsen outcomes. Remember this is Level IV evidence at only 33 months with no control group, so durability against TSA remains unproven.