Osteoarthritis of the trapeziometacarpal joint: The pathophysiology of articular cartilage degeneration. I. Anatomy and pathology of the aging joint

Pellegrini, Vincent D.

doi:10.1016/s0363-5023(10)80054-1

Cited by 219 publications

(143 citation statements)

References 14 publications

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“…The estimated joint contact areas were concentrated on the central-volar region of the trapezium except when the thumb was in excessive adduction. Degenerative osteoarthritis has been reported to occur in this region [14]. We believe, therefore, that our results appear consistent with a characteristic pattern of osteoarthritic lesions.…”

Section: Discussionsupporting

confidence: 91%

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In Vivo Pilot Study Evaluating the Thumb Carpometacarpal Joint During Circumduction

Gotō

Leng

Sugamoto

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Analysis of arthrokinematics may have clinical use in the diagnosis of dynamic instability of the thumb and wrist. Recent technological advances allow noninvasive, high-resolution imaging of skeletal (thumb and carpal bones) structures during motion. Questions/purposes The primary purpose of this study is to define the arthrokinematics, estimated joint contact patterns, and distribution ratios of the carpometacarpal joint of the thumb using four-dimensional CT (three-dimensional CT + time) and registration algorithms. The second purpose is to validate the accuracy of the approach. Methods Four-dimensional CT scans were obtained using a nongated sequential scanning technique. Eighteen image volumes were reconstructed over a 2-second cycle during thumb circumduction in one healthy volunteer. Using a registration algorithm, serial thumb motions as well as estimated joint contact areas were quantified. To evaluate the accuracy of our approach, one cadaveric hand was used. Results During circumduction, the ranges of motion of the thumb carpometacarpal joint were: flexion-extension, 27.3°; adduction-abduction, 66.9°; and pronation-supination, 10°. The magnitude of the translation of the center of the estimated joint contact area of the metacarpal was 4.1, 4.0, 1.0, and 1.5 mm when moving from the initial key pinch position to adduction, adduction to palmar abduction, palmar abduction to opposition, and opposition to the initial key pinch position, respectively. The maximum estimated contact area on the trapezium and on the metacarpal was in palmar abduction; the minimum was in adduction. Dominant central-volar contact patterns were observed on both the trapezium and the metacarpal bone except in adduction. This analysis approach had an average rotational error of less than 1°.

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Section: Discussionsupporting

confidence: 91%

“…Consequently, high contact stresses occur at the thumb CMC joint, which may lead to degenerative joint disease. In addition, the shear stresses in this area are increased by laxity of the volar-anterior or palmar beak ligaments [14].…”

Section: Discussionmentioning

confidence: 99%

In Vivo Pilot Study Evaluating the Thumb Carpometacarpal Joint During Circumduction

Gotō

Leng

Sugamoto

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…This suggests a concept of physiological peak forces through the middle and ulnar columns in healthy CMC I joints and underlines the importance of the palmar beak ligament that holds the joint centered and distributes the forces across a greater surface. 39,40 The three compartments of the osteoarthritic trapezia-radial, middle, and ulnar-revealed an individual bone reaction to the osteoarthritic disease. Higher bone volume fraction (BV/TV) in osteoarthritis as a measure for apparent bone mineral density was most pronounced in the radial compartment (Fig.…”

Section: Discussionmentioning

confidence: 99%

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Nufer

Goldhahn

Köhler

et al. 2007

Journal Orthopaedic Research

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Although the thumb saddle is one of the most common sites of degenerative osteoarthritis in the hand, little is known about the altered microstructure in osteoarthritic trapezial bones. External forces resulting from subluxation of the carpometacarpal joint of the thumb (CMC I) should provoke microstructural changes in the trapezium. The purpose of this study was to compare the regional differences of the microstructure between osteoarthritic and healthy trapezial bones. Fifteen trapezia harvested from female patients with radiologically and clinically diagnosed saddle joint osteoarthritis (OA) were compared with 15 unaffected controls. Microstructural parameters, such as bone volume ratio (BV/TV), three-dimensional connectivity (Conn.D), trabecular number (Tb.N), and trabecular thickness (Tb.Th) were studied using a microcomputed tomography (microCT) system. While the trapezial height in OA was 22% less, the sclerotic subchondral bone layer thickness was 50% higher in OA compared with the control group (p < 0.001). In the OA group there was a 42% higher bone volume ratio (p 0.001), an 18% increase in Tb.Th (p ¼ 0.006), and a 10% greater Tb.N (p ¼ 0.034) compared with the control group. Although in both groups BV/TV was significantly lower in the radial region, the radial column showed the highest relative increase in bone volume and structure compared with the control group (þ67% BV/TV, þ20% Tb.Th, þ23% Tb.N). The reinforcement of the bony microstructure in CMC I OA, especially at the radial side, is a sign for bone adaptation reacting to radially shifted joint forces. This has to be considered during the development of new prosthetic alternatives. ß

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“…Arthritis of this joint more commonly occurs in women than in men, starting in middle adulthood and increasing in prevalence with age [14]; radiographic prevalence ranging from 33% of postmenopausal women [1] to as high as 100% of women older than 91 years is described [4]. The anterior oblique ligament incompetence has been shown to play a role in the progression of CMC arthritis [3,7,19,20].…”

Section: Historymentioning

confidence: 99%

Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

Kennedy

Manske

Huang

2016

Clinical Orthopaedics &Amp; Related Research

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Osteoarthritis of the trapeziometacarpal joint: The pathophysiology of articular cartilage degeneration. I. Anatomy and pathology of the aging joint

Cited by 219 publications

References 14 publications

In Vivo Pilot Study Evaluating the Thumb Carpometacarpal Joint During Circumduction

In Vivo Pilot Study Evaluating the Thumb Carpometacarpal Joint During Circumduction

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

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