Highlights
- •Morphological changes observed in the trapezium and first metacarpalare different in subjects with stable vs progressive osteoarthritis
- •The volar beak of the first metacarpal recesses rapidly in progressive thumb osteoarthritis
- •Flattening of the volar beak and loss of convex curvature of the first metacarpal may link instability to altered joint contact location and mechanics
- •Progressive changes in first metacarpal morphology are important in evaluating CMC OA disease progression and treatment
Abstract
Background
Thumb carpometacarpal osteoarthritis is characterized by osteophyte growth and changes
in the curvature of the articular surfaces of the trapezium and first metacarpal.
The aim of this longitudinal study was to quantify in-vivo bone morphology changes
with osteoarthritis progression.
Methods
The study analyzed an observational dataset of 86 subjects with early thumb osteoarthritis
and 22 age-matched asymptomatic controls. CT scans of subjects' affected hands were
acquired at enrollment (year 0), and at 1.5, 3, 4.5, and 6-year follow-up visits.
Osteoarthritic subjects were classified into stable and progressive groups, as defined
by osteophyte volume and the rate of osteophyte growth. Trapezium height, width, and
volar facet recession, along with first metacarpal volar beak recession and recession
angle, were quantified.
Findings
Mean trapezium width increased 12% over six years in the progressive osteoarthritis
group. Trapezium volar recession of the progressive osteoarthritis group was significantly
greater than stable at enrollment (P < 0.0001) and year 6 (P < 0.0001). The first metacarpal volar beak of the progressive osteoarthritis group
recessed significantly faster than stable (P = 0.0004) and control (P = 0.0003). In year 6, volar beak surfaces in subjects with progressive osteoarthritis
were flatter with reduced curvature, measuring −8.7 ± 4.0 degrees, compared to the
stable osteoarthritis (P < 0.0001) and control groups (P = 0.0003), which maintained nominal curvatures, measuring 0.7 ± 2.5 and 0.2 ± 3.2 degrees,
respectively.
Interpretation
Our results demonstrate significant recession and reduction in the angle of the first
metacarpal volar beak in progressive osteoarthritis. Flattening of the first metacarpal
volar beak may have important associations with carpometacarpal joint contact and
loading migrations, further propagating osteophyte formation and bony remodeling.
This work highlights the volar beak of the first metacarpal as a region of morphology
change with disease.
Keywords
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Article info
Publication history
Published online: October 05, 2022
Accepted:
October 2,
2022
Received:
July 5,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
