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Bone morphological changes of the trapezium and first metacarpal with early thumb osteoarthritis progression

  • Author Footnotes
    1 Co-first authors
    Amy M. Morton
    Footnotes
    1 Co-first authors
    Affiliations
    Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
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  • Author Footnotes
    1 Co-first authors
    Leah J. Peipert
    Footnotes
    1 Co-first authors
    Affiliations
    Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
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  • Douglas C. Moore
    Affiliations
    Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
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  • Amy L. Ladd
    Affiliations
    Robert A. Chase Hand & Upper Limb Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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  • Arnold-Peter C. Weiss
    Affiliations
    Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905, USA
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  • Janine Molino
    Affiliations
    Department of Orthopaedics, The Warren Alpert Medical School of Brown University/University Orthopedics, 2 Dudley Street, Suite 200, Providence, RI 02905, USA
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  • Joseph J. Crisco
    Correspondence
    Corresponding author.
    Affiliations
    Bioengineering Laboratory, Department of Orthopaedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, 1 Hoppin Street, CORO West Suite 404, Providence, RI 02903, USA
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  • Author Footnotes
    1 Co-first authors

      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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