ReviewJSES reviews, reports, and techniques2026
Pyrocarbon implants in shoulder arthroplasty: a systematic review and meta-analysis.
Review in JSES reviews, reports, and techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Chrome-cobalt alloy, pyrocarbon (PyC), and ceramic have all been used for humeral head replacement in shoulder arthroplasty. It remains unclear whether outcomes differ by material. PyC implants are increasingly used, including PyC interposition shoulder arthroplasty (PISA) and PyC hemiarthroplasty (HA-PyC). The objective of the present study is to systematically evaluate implant survival, functional outcomes (Constant score, visual analog scale for pain, and Subjective Shoulder Value), revision rates (defined as any reoperation involving implant removal, replacement, or conversion), complications, and radiological changes associated with PyC in shoulder arthroplasty. Methods: A systematic review and meta-analysis was performed. MEDLINE, Embase, Cochrane, Scopus, and Web of Science were searched on April 25, 2025, without language or date restrictions. Studies with ≥1-year follow-up were included. Data were pooled using random-effects models; quality was assessed using the Methodological Index for Non-Randomized Studies tool, and certainty was graded according to Grading of Recommendations Assessment, Development, and Evaluation guidelines. The protocol was registered in PROSPERO (CRD420251059452). Results: Twenty studies (2017-2025) were included. 1,117 patients had undergone either HA-PyC or PISA. Follow-up ranged from 1 to 11 years. Primary osteoarthritis was the most common indication (31%-86%). Pooled implant survival was 96% (95% confidence interval (CI), 94%-98%) at the most recent follow-up, with substantial heterogeneity (I Conclusions: The reported survival rate of stemmed HA-PyC is high and encouraging. When PyC has been used for resurfacing HA or in the form of interposition (PISA), reported survivorship has been inferior. Careful patient selection and surgical technique are essential. Further high-quality comparative trials are required to clarify long-term benefits and material-specific risks.
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