Quantitative analysis of in-vivo thumb carpometacarpal joint kinematics using four-dimensional computed tomography

The purpose of this study was to define the normal thumb carpometacarpal joint kinematics in-vivo during opposition and abduction using four-dimensional computed-tomography in four volunteers. Movement of the metacarpal relative to the trapezium was quantified using both Euler and helical axis representations. Articular surface contact patterns were also analysed. The overall axis of rotation for the movement of opposition and abduction passes through the trapezium and the base of the proximal phalanx, respectively. An abrupt change in instantaneous axis of rotation at terminal opposition was found. Ligament modelling shows dorsoradial ligament becomes tauter towards terminal opposition, whereas anterior oblique ligament becomes more slack. These results support the existence of the ‘screw-home’ pivot at terminal opposition and the importance of the dorsoradial ligament for stability in this position. The normal reference set in this study can help establish a diagnostic tool for subtle carpometacarpal instability, or for evaluating efficacy of surgery.

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In Vivo Kinematics of the Thumb Carpometacarpal Joint During Flexion and Abduction

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835521500041 ◽

2020 ◽

Author(s):

Kaoru Tada ◽

Hiroshi Tachiya ◽

Akihiro Kurosawa ◽

Mika Nakada ◽

Masashi Matsuta ◽

...

Keyword(s):

Carpometacarpal Joint ◽

Thumb Carpometacarpal Joint ◽

In Vivo Kinematics ◽

Thumb Carpometacarpal

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In Vivo Length and Changes of Ligaments Stabilizing the Thumb Carpometacarpal Joint

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2010.11.007 ◽

2011 ◽

Vol 36 (3) ◽

pp. 420-427 ◽

Cited By ~ 11

Author(s):

Jun Tan ◽

Jing Xu ◽

Ren Guo Xie ◽

Ai Dong Deng ◽

Jin Bo Tang

Keyword(s):

Carpometacarpal Joint ◽

Thumb Carpometacarpal Joint ◽

Thumb Carpometacarpal

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Thumb Carpometacarpal Joint Pathoanatomy—A Computed Tomography-Based Study

Journal of Wrist Surgery ◽

10.1055/s-0041-1726310 ◽

2021 ◽

Author(s):

Karam Al-Tawil ◽

Madeleine Garner ◽

Tony Antonios ◽

Jonathan Compson

Keyword(s):

Computed Tomography ◽

Three Dimensional ◽

Ct Scanning ◽

Carpometacarpal Joint ◽

Level Of Evidence ◽

Thumb Carpometacarpal Joint ◽

Preoperative Ct ◽

Ulnar Aspect ◽

Potential Damage ◽

Thumb Carpometacarpal

Abstract Background Thumb carpometacarpal joint (CMCJ) osteoarthritis is common and can lead to significant morbidity making it a condition frequently treated by hand surgeons when initial conservative measures fail. The surrounding ligamentous structures are complex and important to maintain thumb CMCJ stability. Objectives The aim of this study was to review the normal and arthritic anatomy of the thumb CMCJ, focusing on morphology and position of osteophytes and the gap between metacarpal bases, and the effect of these on intermetacarpal ligament integrity. This may be the sole ligament suspending the first metacarpal following trapeziectomy and could determine the need for further stabilization during surgery, avoiding potential future failures. Methods Computed tomography (CT) scans of a normal cohort and those with arthritic changes who had undergone trapeziectomy following the scan were identified. The three-dimensional reconstructions were examined for osteophyte position on the saddle and the intermetacarpal distance. Results A total of 55 patients, 30 normal and 25 arthritic, were identified and studied. The most common anatomic position for osteophytes was the intermetacarpal ulnar aspect of the trapezium. The intermetacarpal distance increased by an average of 2.1 mm in the presence of the arthritic process. Conclusions The findings point to an increase in the intermetacarpal distance, and hence lengthening of the ligament with potential damage, possibly secondary to osteophyte formation and wear. Further prospective research is required to determine whether using preoperative CT scanning to define osteophyte position and measure the intermetacarpal distance would predict probable damage to the ligament, hence providing an indication for stabilization and reconstruction in trapeziectomy surgery. Level of Evidence This is a Level III, retrospective cohort study.

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In Vivo Biomechanics of Thumb Carpometacarpal Joint: A Preliminary Study of Gender Differences

Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotransport Phenomena; Bone, Joint and Spine Mechanics; Brain Injury; Cardiac Mechanics; Cardiovascular Devices, Fluids and Imaging; Cartilage and Disc Mechanics; Cell and Tissue Engineering; Cerebral Aneurysms; Computational Biofluid Dynamics; Device Design, Human Dynamics, and Rehabilitation; Drug Delivery and Disease Treatment; Engineered Cellular Environments ◽

10.1115/sbc2013-14194 ◽

2013 ◽

Author(s):

Qi Zheng ◽

Phil Lee ◽

Terence E. McIff ◽

E. Bruce Toby ◽

Kenneth J. Fischer

Keyword(s):

Gender Differences ◽

In Vivo Studies ◽

Joint Mechanics ◽

Carpometacarpal Joint ◽

Thumb Carpometacarpal Joint ◽

Thumb Movement ◽

Males And Females ◽

Thumb Carpometacarpal ◽

Functional Loading

The thumb carpometacarpal joint, which is also known as the trapeziometacarpal (TMC) joint, is an essential load bearing joint subject to repetitive functional loading. The unique double saddle articular surfaces allow complex thumb movement, but also provide bony constraint. The TMC joint is the second most common hand joint affected by osteoarthritis (OA) [1]. Prior studies suggest that TMC OA prevalence in females is much higher than that in males [1], though there hasn’t been any conclusive explanation for etiology or gender difference. Better understanding of TMC joint mechanics will provide insights regarding OA development at this joint and possible variations due to gender differences. Better knowledge of the etiology will help to improve prevention and treatment. Extensive studies have been done based on cadaveric models [2]; while there have been very few in vivo studies on TMC joint mechanics. Therefore, the objective of this study is to quantitatively compare in vivo contact mechanics of TMC joint of males and females.

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