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.
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.
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.
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.
The healthy CMC joint is relatively stable during key pinch, jar grasp, and jar twist tasks, despite sex and age group.
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.
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We thank Jason T. Machan PhD for his help with the statistical analysis, James C. Tarrant for his help with data processing, and Bethany J. Wilcox BS for designing the LabVIEW™ subroutines used in collecting the load cell data.
The institutions of the authors have received, during the study period, funding from NIAMS/NIH (Bethesda, MD, USA) under Grant Number AR059185 (JJC) and from the American Foundation for Surgery of the Hand (Chicago, IL, USA) (CG). The contents of this manuscript are the responsibility of the authors and do not necessarily represent the official views of the NIAMS or NIH.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at Rhode Island Hospital, Brown University (Providence, RI, USA) and Stanford University School of Medicine (Stanford, CA, USA).
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Halilaj, E., Rainbow, M.J., Got, C. et al. In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks. Clin Orthop Relat Res 472, 1114–1122 (2014). https://doi.org/10.1007/s11999-013-3063-y
- Neutral Position
- Joint Laxity
- Functional Task
- Surface Translation
- Wrist Position