STT arthritis is a well-known problem generated idiopathically or secondary to a greater mobility of the scaphoid, for example after scapho-lunate ligament lesions. In these cases, the pure resection of the STT joint would add more instability to the whole system. Therefore, alternatively to the simple resection arthroplasty, the prosthetic augmentation has been proposed. We report the experience with a pyrocarbone convex-concave-shaped prosthesis, which adapts anatomically in the STT joint. After the arthroscopic resection of the distal scaphoid pole, the pyrocarbone implant can be positioned. Three weeks of immobilization seem convenient. In a series of 15 Prof. Christophe Mathoulin’s patients, very good results were achieved after a 39-month follow-up period. Two cases failed because of incomplete resection, especially at the most medial side towards the capitate, which should be approached in this area with accuracy. Arthroscopic resection and pyrocarbone prosthesis have provided very good results in isolated STT arthritis, but remain a new therapeutic option whose validity will have to be proven over the next years.