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

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...

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Published in:Clinical orthopaedics and related research 2014-04, Vol.472 (4), p.1114-1122
Main Authors: Halilaj, Eni, Rainbow, Michael J., Got, Christopher, Schwartz, Joel B., Moore, Douglas C., Weiss, Arnold-Peter C., Ladd, Amy L., Crisco, Joseph J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Biomechanical Phenomena
Carpometacarpal Joints - diagnostic imaging
Carpometacarpal Joints - physiology
Conservative Orthopedics
Female
Hand
Hand Strength
Humans
Isometric Contraction
Male
Medicine
Medicine & Public Health
Metacarpal Bones - diagnostic imaging
Metacarpal Bones - physiology
Middle Aged
Movement
Orthopedics
Radiographic Image Interpretation, Computer-Assisted
Range of Motion, Articular
Sex Factors
Sports Medicine
Surgery
Surgical Orthopedics
Symposium: Thumb Carpometacarpal Arthritis
Thumb - physiology
Tomography, X-Ray Computed
Trapezium Bone - diagnostic imaging
Trapezium Bone - physiology
Weight-Bearing
Young Adult
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Summary: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.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-013-3063-y