Imaging the Ligaments of the Trapeziometacarpal Joint: MRI Compared with MR Arthrography in Cadaveric Specimens

Cardoso, Fabiano Nassar; Kim, Hyun‐Jin; Albertotti, Flávio; Botte, Michael J.; Resnick, D; Chung, Christine B.

doi:10.2214/ajr.07.4010

Cited by 24 publications

(18 citation statements)

References 25 publications

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“…In vivo studies should provide further insight into the role of each of these two ligaments on the stability of the active joint. Several studies have identified the major CMC joint ligaments with MRI and ultrasound (Cardoso et al, 2009; D’Agostino et al, 2014; Gondim Teixeira et al, 2011), without providing a quantitative analysis of their function. There is a limited number of published in vivo studies (Tan et al, 2011) that have explored the roles of these ligaments on joint stability, mainly because assessing ligament function in vivo remains challenging.…”

Section: Introductionmentioning

confidence: 99%

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

Halilaj

Rainbow

Moore

et al. 2015

Journal of Biomechanics

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The anterior oblique ligament (AOL) and the dorsoradial ligament (DRL) are both regarded as mechanical stabilizers of the thumb carpometacarpal (CMC) joint, which in older women is often affected by osteoarthritis. Inferences on the potential relationship of these ligaments to joint pathomechanics are based on clinical experience and studies of cadaveric tissue, but their function has been studied sparsely in vivo. The purpose of this study was to gain insight into the functions of the AOL and DRL using in vivo joint kinematic data. The thumbs of 44 healthy subjects were imaged with a clinical computed tomography scanner in functional-task and thumb range-of-motion positions. The origins and insertion sites of the AOL and the DRL were identified on the 3D bone models and each ligament was modeled as a set of three fibers whose lengths were the minimum distances between insertion sites. Ligament recruitment, which represented ligament length as a percentage of the maximum length across the scanned positions, was computed for each position and related to joint posture. Mean AOL recruitment was lower than 91% across the CMC range of motion, whereas mean DRL recruitment was generally higher than 91% in abduction and flexion. Under the assumption that ligaments do not strain by more than 10% physiologically, our findings of mean ligament recruitments across the CMC range of motion indicate that the AOL is likely slack during most physiological positions, whereas the DRL may be taut and therefore support the joint in positions of CMC joint abduction and flexion.

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Section: Introductionmentioning

confidence: 99%

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

Halilaj

Rainbow

Moore

et al. 2015

Journal of Biomechanics

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“…The trapeziometacarpal joint, or first CMC joint, is a "saddle-type" joint with concave and convex surfaces on each side, and it is dependent on multiple ligaments for stability and support (3). There is a degree of inherent instability in the first CMC joint that allows the wide arc of thumb motion; however, this instability is also responsible for the tendency of the joint to have degenerative change if the supporting ligaments become lax (4). Although up to 16 ligaments were described at dissections around the first CMC joint in cadaveric hands (1), the following five ligaments have the most integral roles in maintaining joint stability: the dorsal radial ligament, posterior oblique ligament, intermetacarpal ligament, anterior oblique ligament (AOL), and UCL (4).…”

Section: Dorsal and Volar Ligaments Of The First Cmc Jointmentioning

confidence: 99%

“…There is a degree of inherent instability in the first CMC joint that allows the wide arc of thumb motion; however, this instability is also responsible for the tendency of the joint to have degenerative change if the supporting ligaments become lax (4). Although up to 16 ligaments were described at dissections around the first CMC joint in cadaveric hands (1), the following five ligaments have the most integral roles in maintaining joint stability: the dorsal radial ligament, posterior oblique ligament, intermetacarpal ligament, anterior oblique ligament (AOL), and UCL (4). The relative importance of the various ligaments has been debated in the surgery literature (1,5), with a shift from the belief that the AOL is the most functionally important ligament to the belief that the dorsal ligaments are as important as the AOL for stability (4).…”

Section: Dorsal and Volar Ligaments Of The First Cmc Jointmentioning

confidence: 99%

“…Although up to 16 ligaments were described at dissections around the first CMC joint in cadaveric hands (1), the following five ligaments have the most integral roles in maintaining joint stability: the dorsal radial ligament, posterior oblique ligament, intermetacarpal ligament, anterior oblique ligament (AOL), and UCL (4). The relative importance of the various ligaments has been debated in the surgery literature (1,5), with a shift from the belief that the AOL is the most functionally important ligament to the belief that the dorsal ligaments are as important as the AOL for stability (4). However, when first CMC joint reconstruction is performed, the AOL is the primary ligament reconstructed-typically by using the flexor carpi radialis tendon (6).…”

Section: Dorsal and Volar Ligaments Of The First Cmc Jointmentioning

confidence: 99%

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High-Resolution MR Imaging and US Anatomy of the Thumb

Rawat¹,

Pierce²,

Evans³

et al. 2016

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Despite having many unique anatomic features relative to the other digits, the thumb has received little attention in the radiology literature. The thumb, with its opposable and prehensile abilities, enables fine manual dexterity. However, most radiologists have little familiarity with the structures that allow these dynamic movements, other than their recognition of the role of the ulnar collateral ligament in the setting of gamekeeper injury. High-resolution magnetic resonance (MR) imaging allows optimal assessment of the intricate soft-tissue anatomy of the thumb, which enables thumb flexion, extension, abduction, and adduction. Ultrasonography is a readily available, inexpensive tool that can supplement MR imaging in the evaluation of juxta-articular soft-tissue anatomy. Both imaging modalities are extremely useful for identifying the key ligaments responsible for stabilizing the first carpometacarpal and metacarpophalangeal joints. MR imaging is particularly important in assessment of these ligaments in both normal and trauma settings, which is essential for not only recognizing acute injuries but also becoming familiar with the morphologic variations that are potential pitfalls. To accurately and confidently diagnose abnormalities of these small soft-tissue structures, radiologists must have a clear understanding of the complexities associated with imaging the normal thumb anatomy. RSNA, 2016.

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“…Dies ergibt sich einerseits aufgrund seines anatomischen Verlaufs und andererseits aus der funktionellen Beanspruchung. Das AOL liegt intrakapsulär und wurde bereits arthroskopisch in ein oberflächliches ("superficial anterior oblique ligament", sAOL) und ein tiefes ("deep anterior oblique ligament", dAOL) Band unterteilt [5,6]. In unserer Arbeit konnten wir keine Unterscheidung dieser beiden Anteile vornehmen, was in Einklang steht mit den Ergebnissen auch anderer Autoren [9].…”

Section: Diskussionunclassified