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Impact of osteoarthritis and total joint arthroplasty on the kinematics of the trapeziometacarpal joint: a pilot study

Journal Contribution - Journal Article

PurposeTo quantify the effect of osteoarthritis (OA) and total trapeziometacarpal (TMC) joint replacement on thumb kinematics during the primary physiological motions of the thumb.MethodsWe included 4 female patientswith stage III TMC OA. A computed tomography based markerless method was used to quantify the 3-dimensional thumb kinematics in patients before and after TMC joint replacement surgery with the Arpe implant.ResultsTrapeziometacarpal OA led to a marked decrease of internal rotation and abduction of the first metacarpal (MC1) during thumb flexion and a decrease of MC1 adduction duringthumb adduction. As a compensatory phenomenon, the trapezium displayed increased abduction. The absence of MC1 translation in the ball-and-socket implant seems to induce adecrease of MC1 adduction as well as a decrease of trapezium adduction during thumb adduction, compared with OA and healthy joints. Implant replacement displayed an unchangedMC1 flexion during thumb flexion and seemed to slightly increase MC1 axial rotation during thumb flexion and adduction. Abduction and adduction of the MC1 are limitedand compensated by this somewhat increased axial rotation, allowing more efficient thumb opposition.ConclusionsThe study highlights that advanced TMC OA mainly restricts the MC1 mobility. We also showed that, whereas total joint arthroplasty is able to restore thumb function, itcannot fully replicate the kinematics of the healthy TMC joint.Clinical relevanceThe quantification of TMC joint kinematics in OA and implanted patients is essential to improve our understanding of TMC OA as well as to enhance the functionality ofimplant designs.
Journal: Journal of Hand Surgery
ISSN: 0363-5023
Issue: 4
Volume: 43
Number of pages: 10
Publication year:2018
Keywords:Rheumatology/orthopedics, Surgery