Prospective multicenter case series of 65 young patients who underwent hemi-shoulder arthroplasty with a new pyrolytic carbon humeral head. It asks whether pyrocarbon can deliver good function while avoiding the glenoid erosion that limits metallic-head hemiarthroplasty. Outcomes are reported at a 2-year minimum follow-up across several etiologies.
Match the implant to the etiology, not just the diagnosis of shoulder arthritis. Primary OA, post-instability secondary OA, and atraumatic osteonecrosis with an intact cuff did well with pyrocarbon HSA, while fracture sequelae (post-traumatic secondary OA or osteonecrosis) did poorly and should point you toward reverse arthroplasty or interposition instead.
The main appeal is preserving the native glenoid in young patients, avoiding the glenoid component complications of TSA and the burned bridges of RSA. Here 86% of glenoids showed no erosion progression at 2 years, though this is only Level IV evidence with no control group and short follow-up.
Know the Walch classification cold: type A is centered, type B has posterior subluxation and eccentric wear. The authors report good B1/B2 outcomes and a re-centering effect, but explicitly advise against pyrocarbon HSA for B2 glenoids until longer data exist. Use a convertible stem so a failed anatomic head can be swapped to reverse without removing well-fixed hardware.
Prospective multicenter case series of 65 young patients who underwent hemi-shoulder arthroplasty with a new pyrolytic carbon humeral head. It asks whether pyrocarbon can deliver good function while avoiding the glenoid erosion that limits metallic-head hemiarthroplasty. Outcomes are reported at a 2-year minimum follow-up across several etiologies.
Match the implant to the etiology, not just the diagnosis of shoulder arthritis. Primary OA, post-instability secondary OA, and atraumatic osteonecrosis with an intact cuff did well with pyrocarbon HSA, while fracture sequelae (post-traumatic secondary OA or osteonecrosis) did poorly and should point you toward reverse arthroplasty or interposition instead.
The main appeal is preserving the native glenoid in young patients, avoiding the glenoid component complications of TSA and the burned bridges of RSA. Here 86% of glenoids showed no erosion progression at 2 years, though this is only Level IV evidence with no control group and short follow-up.
Know the Walch classification cold: type A is centered, type B has posterior subluxation and eccentric wear. The authors report good B1/B2 outcomes and a re-centering effect, but explicitly advise against pyrocarbon HSA for B2 glenoids until longer data exist. Use a convertible stem so a failed anatomic head can be swapped to reverse without removing well-fixed hardware.