Clinical Orthopaedics and Related Research®

, Volume 472, Issue 4, pp 1114–1122 | Cite as

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

  • Eni Halilaj
  • Michael J. Rainbow
  • Christopher Got
  • Joel B. Schwartz
  • Douglas C. Moore
  • Arnold-Peter C. Weiss
  • Amy L. Ladd
  • Joseph J. Crisco
Symposium: Thumb Carpometacarpal Arthritis

Abstract

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.

References

  1. 1.
    Acheson RM, Chan YK, Clemett AR. New Haven survey of joint diseases. XII. Distribution and symptoms of osteoarthrosis in the hands with reference to handedness. Ann Rheum Dis. 1970;29:275–286.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Armstrong AL, Hunter JB, Davis TR. The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women. J Hand Surg Br. 1994;19:340–341.PubMedCrossRefGoogle Scholar
  3. 3.
    Cerveri P, De Momi E, Marchente M, Baud-Bovy G, Scifo P, Barros RM, Ferrigno G. Method for the estimation of a double hinge kinematic model for the trapeziometacarpal joint using MR imaging. Comput Methods Biomech Biomed Engin. 2010;13:387–396.PubMedCrossRefGoogle Scholar
  4. 4.
    Cerveri P, De Momi E, Marchente M, Lopomo N, Baud-Bovy G, Barros RM, Ferrigno G. In vivo validation of a realistic kinematic model for the trapezio-metacarpal joint using an optoelectronic system. Ann Biomed Eng. 2008;36:1268–1280.PubMedCrossRefGoogle Scholar
  5. 5.
    Chang JH, Ho KY, Su FC. Kinetic analysis of the thumb in jar-opening activity among female adults. Ergonomics. 2008;51:843–857.PubMedCrossRefGoogle Scholar
  6. 6.
    Chang LY, Pollard NS. Method for determining kinematic parameters of the in vivo thumb carpometacarpal joint. IEEE Trans Biomed Eng. 2008;55:1897–1906.PubMedCrossRefGoogle Scholar
  7. 7.
    Chèze L, Dumas R, Comtet JJ, Rumelhart C, Fayet M. A joint coordinate system proposal for the study of the trapeziometacarpal joint kinematics. Comput Methods Biomech Biomed Engin. 2009;12:277–82.PubMedCrossRefGoogle Scholar
  8. 8.
    Chèze L, Dumas R, Comtet JJ, Rumelhart C, Fayet M. Determination of the number of degrees of freedom of the trapeziometacarpal joint—an in vitro study. IRBM. 2012;33:272–277.CrossRefGoogle Scholar
  9. 9.
    Cooney WP 3rd, Lucca MJ, Chao EY, Linscheid RL. The kinesiology of the thumb trapeziometacarpal joint. J Bone Joint Surg Am. 1981;63:1371–1381.PubMedGoogle Scholar
  10. 10.
    Fregly BJ, Banks SA, D’Lima DD, Colwell CW. Sensitivity of knee replacement contact calculations to kinematic measurement errors. J Orthop Res. 2008;26:1173–1179.PubMedCrossRefGoogle Scholar
  11. 11.
    Haara MM, Heliövaara M, Kröger H, Arokoski JPA, Manninen P, Kärkkäinen A, Knekt P, Impivaara O, Aromaa A. Osteoarthritis in the carpometacarpal joint of the thumb: prevalence and associations with disability and mortality. J Bone Joint Surg Am. 2004;86:1452–1457.PubMedGoogle Scholar
  12. 12.
    Halilaj E, Rainbow MJ, Got CJ, Moore DC, Crisco JJ. A thumb carpometacarpal joint coordinate system based on articular surface geometry. J Biomech. 2013;46:1031–1034.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Hollister A, Buford WL, Myers LM, Giurintano DJ, Novick A. The axes of rotation of the thumb carpometacarpal joint. J Orthop Res. 1992;10:454–460.PubMedCrossRefGoogle Scholar
  14. 14.
    Hunter DJ, Wilson DR. Role of alignment and biomechanics in osteoarthritis and implications for imaging. Radiol Clin North Am. 2009;47:553–566.PubMedCrossRefGoogle Scholar
  15. 15.
    Imaeda T, Niebur G, Cooney WP 3rd, Linscheid RL, An KN. Kinematics of the normal trapeziometacarpal joint. J Orthop Res. 1994;12:197–204.PubMedCrossRefGoogle Scholar
  16. 16.
    Koff MF, Ugwonali OF, Strauch RJ, Rosenwasser MP, Ateshian GA, Mow VC. Sequential wear patterns of the articular cartilage of the thumb carpometacarpal joint in osteoarthritis. J Hand Surg Am. 2003;28:597–604.PubMedCrossRefGoogle Scholar
  17. 17.
    Kuczynski K. Carpometacarpal joint of the human thumb. J Anat. 1974;118:119–126.PubMedCentralPubMedGoogle Scholar
  18. 18.
    Kuo LC, Cooney WP, Chen QS, Kaufman KR, Su FC, An KN. A kinematic method to calculate the workspace of the trapeziometacarpal joint. Proc Inst Mech Eng H. 2004;218:143–149.PubMedCrossRefGoogle Scholar
  19. 19.
    Kuo LC, Cooney WP 3rd, An KN, Lai KY, Wang SM, Su FC. Effects of age and gender on the movement workspace of the trapeziometacarpal joint. Proc Inst Mech Eng H. 2009;223:133–142.PubMedCrossRefGoogle Scholar
  20. 20.
    Lee AT, Williams AA, Lee J, Cheng R, Lindsey DP, Ladd AL. Trapezium trabecular morphology in carpometacarpal arthritis. J Hand Surg Am. 2013;38:309–315.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Lin HT, Kuo LC, Liu HY, Wu WL, Su FC. The three-dimensional analysis of three thumb joints coordination in activities of daily living. Clin Biomech Bristol, Avon. 2011;26:371–376.PubMedCrossRefGoogle Scholar
  22. 22.
    Marai GE, Laidlaw DH, Crisco JJ. Super-resolution registration using tissue-classified distance fields. IEEE Trans Med Imaging. 2006;25:1–11.CrossRefGoogle Scholar
  23. 23.
    Marshall M, Van der Windt D, Nicholls E, Myers H, Dziedzic K. Radiographic thumb osteoarthritis: frequency, patterns and associations with pain and clinical assessment findings in a community-dwelling population. Rheumatology (Oxford). 2011;50:735–739.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Mathur K, Pynsent PB, Vohra SB, Thomas B, Deshmukh SC. Effect of wrist position on power grip and key pinch strength following carpal tunnel decompression. J Hand Surg Br. 2004;29:390–392.PubMedCrossRefGoogle Scholar
  25. 25.
    Moritomo H, Viegas SF, Elder K, Nakamura K, Dasilva MF, Patterson RM. The scaphotrapezio-trapezoidal joint. Part 2: a kinematic study. J Hand Surg Am. 2000;25:911–920.PubMedCrossRefGoogle Scholar
  26. 26.
    Napier JR. The form and function of the carpo-metacarpal joint of the thumb. J Anat. 1955;89:362–369.PubMedCentralPubMedGoogle Scholar
  27. 27.
    Patterson RM, Nicodemus CL, Viegas SF, Elder KW, Rosenblatt J. High-speed, three-dimensional kinematic analysis of the normal wrist. J Hand Surg Am. 1998;23:446–453.PubMedCrossRefGoogle Scholar
  28. 28.
    Pellegrini VD. The ABJS 2005 Nicolas Andry Award. Osteoarthritis and injury at the base of the human thumb: survival of the fittest? Clin Orthop Relat Res. 2005;438:266–276.PubMedCrossRefGoogle Scholar
  29. 29.
    Pieron AP. The mechanism of the first carpometacarpal (CMC) joint: an anatomical and mechanical analysis. Acta Orthop Scand Suppl. 1973;148:1–104.PubMedGoogle Scholar
  30. 30.
    Silverstein B, Welp E, Nelson N, Kalat J. Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995. Am J Public Health. 1998;88:1827–1833.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Tang J, Zhang X, Li ZM. Operational and maximal workspace of the thumb. Ergonomics. 2008;51:1109–1118.PubMedCrossRefGoogle Scholar
  32. 32.
    Wu G, Van der Helm FC, Veeger HE, Makhsous M, Van Roy P, Anglin C, Nagels J, Karduna AR, McQuade K, Wang X, Werner FW, Buchholz B. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion. Part II: shoulder, elbow, wrist and hand. J Biomech. 2005;38:981–992.PubMedCrossRefGoogle Scholar
  33. 33.
    Xu L, Strauch RJ, Ateshian GA, Pawluk RJ, Mow VC, Rosenwasser MP. Topography of the osteoarthritic thumb carpometacarpal joint and its variations with regard to gender, age, site, and osteoarthritic stage. J Hand Surg Am. 1998;23:454–464.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Eni Halilaj
    • 1
  • Michael J. Rainbow
    • 2
  • Christopher Got
    • 3
  • Joel B. Schwartz
    • 3
  • Douglas C. Moore
    • 3
  • Arnold-Peter C. Weiss
    • 3
  • Amy L. Ladd
    • 4
  • Joseph J. Crisco
    • 1
    • 3
  1. 1.Center for Biomedical Engineering and School of EngineeringBrown UniversityProvidenceUSA
  2. 2.Department of Physical Medicine and RehabilitationHarvard Medical SchoolCambridgeUSA
  3. 3.Department of OrthopaedicsThe Warren Alpert Medical School of Brown University and Rhode Island HospitalProvidenceUSA
  4. 4.Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic SurgeryStanford University School of MedicineStanfordUSA

Personalised recommendations