Kinematics of the normal trapeziometacarpal joint

Imaeda, Toshihiko; Niebur, Glen L.; Cooney, William P.; Linscheid, Ronald L.; An, Kai‐Nan ‐N

doi:10.1002/jor.1100120208

Cited by 70 publications

(43 citation statements)

References 24 publications

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“…In a comprehensive marker-based thumb motion study, Tang et al [31] also reported that the first metacarpal generally moves in a direction that is oblique to the anatomy of the CMC joint. In addition, our finding that internal/external rotation of the metacarpal was coupled with flexion/extension and adduction/abduction simultaneously is in agreement with findings from other studies that have reported the flexion/extension and the adduction/ abduction axes as primary axes of motion at the CMC joint and internal/external rotation as a secondary axis of rotation that is coupled with the previous two [8,9,13,15,29].…”

Section: Discussionsupporting

confidence: 92%

“…Yet, a detailed analysis of in vivo 3-D kinematics of the CMC joint has not been reported to date. The existing body of literature is based on cadaver studies [13,15,17,26], skin marker-based studies that track motion of the thumb, but not the trapezium [4,6,9,18,19,21,31], or single-subject imaging studies whose purpose has been to verify that flexion/extension and adduction/abduction are the primary degrees of freedom at the CMC joint [3,7]. Elucidation of OA pathogenesis requires quantitative methods capable of determining both bone rotations (osteokinematics) and articular surface translations (arthrokinematics) and large samples from different demographic groups.…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Halilaj

Rainbow

Got

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The thumb carpometacarpal (CMC) joint is often affected by osteoarthritis-a mechanically mediated disease. Pathomechanics of the CMC joint, however, are not thoroughly understood due to a paucity of in vivo data. Questions/purposes We documented normal, in vivo CMC joint kinematics during isometric functional tasks. We hypothesized there would be motion of the CMC joint during these tasks and that this motion would differ with sex and age group. We also sought to determine whether the rotations at the CMC joint were coupled and whether the trapezium moved with respect to the third metacarpal. Methods Forty-six asymptomatic subjects were CT-scanned in a neutral position and during three functional tasks (key pinch, jar grasp, jar twist), in an unloaded and a loaded position. Kinematics of the first metacarpal, third metacarpal, and the trapezium were then computed. Results Significant motion was identified in the CMC joint during all tasks. Sex did not have an effect on CMC joint kinematics. Motion patterns differed with age group, but these differences were not systematic across the tasks. Rotation at the CMC joint was generally coupled and posture of the trapezium relative to the third metacarpal changed significantly with thumb position. Conclusions The healthy CMC joint is relatively stable during key pinch, jar grasp, and jar twist tasks, despite sex and age group. Clinical Relevance Our findings indicate that directionally coupled motion patterns in the CMC joint, which lead to a specific loading profile, are similar in men and women. These patterns, in addition to other, nonkinematic influences, especially in the female population, may contribute to the pathomechanics of the osteoarthritic joint.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Halilaj

Rainbow

Got

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…However, this study advances our understanding of CMC kinematics by demonstrating that coupling of the primary motions with internal-external rotations and translation along the screw axes are continuous functions of the direction of motion. This is in contrast to other studies that have reported minimal or no coupled motions, perhaps because those studies were focused on the primary motions [1,4,[6][7][8]23,[26][27][28], or because the kinematic data were acquired using surface marker-based motion capture systems where skin motion artifact can be large enough to mask the more modest coupled motions. Coupling with internal-external rotations is evident by the nonzero value of ele, in which positive values of ele indicate coupling with internal rotations and negative values of ele indicate coupling with external rotation.…”

Section: Discussionmentioning

confidence: 76%

“…Subsequently, in a review of thumb CMC instability and dislocation, Edmunds proposed that the soft tissues surrounding the CMC joint generate a stabilizing screw-home motion at the end of thumb opposition, indicating a coupling between flexion and internal rotation [2,3]. Previous experimental studies, however, have not reported translational or a rotational coupling motions of the thumb CMC joint consistent with such a screw-home mechanism [1,[4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Envelope of Physiological Motion of the First Carpometacarpal Joint

Crisco

Patel

Halilaj

et al. 2015

Journal of Biomechanical Engineering

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Much of the hand's functional capacity is due to the versatility of the motions at the thumb carpometacarpal (CMC) joint, which are presently incompletely defined. The aim of this study was to develop a mathematical model to completely describe the envelope of physiological motion of the thumb CMC joint and then to examine if there were differences in the kinematic envelope between women and men. In vivo kinematics of the first metacarpal with respect to the trapezium were computed from computed tomography (CT) volume images of 44 subjects (20M, 24F, 40.3 6 17.7 yr) with no signs of CMC joint pathology. Kinematics of the first metacarpal were described with respect to the trapezium using helical axis of motion (HAM) variables and then modeled with discrete Fourier analysis. Each HAM variable was fit in a cyclic domain as a function of screw axis orientation in the trapezial articular plane; the RMSE of the fits was 14.5 deg, 1.4 mm, and 0.8 mm for the elevation, location, and translation, respectively. After normalizing for the larger bone size in men, no differences in the kinematic variables between sexes could be identified. Analysis of the kinematic data also revealed notable coupling of the primary rotations of the thumb with translation and internal and external rotations. This study advances our basic understanding of thumb CMC joint function and provides a complete description of the CMC joint for incorporation into future models of hand function. From a clinical perspective, our findings provide a basis for evaluating CMC pathology, especially the mechanically mediated aspects of osteoarthritis (OA), and should be used to inform artificial joint design, where accurate replication of kinematics is essential for long-term success.

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“…Traditional cadaveric biomechanical studies approximate the force on a joint via applied extrinsic and intrinsic tendon loads and employing mechanical models with simplified joint constructs [26,49,51]. From such models, we understand the progressive force increase from the tip to the CMC joint, with the force across the CMC joint in grasp exceeding that of lateral pinch approximately 10-fold (120 kg versus 12 kg) [25].…”

Section: Next Stepsmentioning

confidence: 99%