Purpose
The pathophysiology of thumb carpometacarpal (CMC) osteoarthritis (OA) involves complex
interactions between the ligaments and muscles supporting the joint. Factors such
as muscle volume and strength may be more relevant in early disease. We used ultrasound
as a noninvasive method to explore differences in the intrinsic hand muscles of patients
with early CMC OA, as determined using physical exam and radiographs, and healthy
controls. We also assessed differences in grip strength.
Methods
A convenience sample of postmenopausal women with early CMC OA diagnosed using a physical
examination or radiographs was recruited from an orthopedic clinic specializing in
hand surgery. Healthy controls who were matched for age and hand dominance were recruited
from the same clinic. We used ultrasound to determine the length of the first metacarpal
and the muscle thickness of the abductor pollicis brevis, opponens pollicis (OPP),
and first dorsal interosseous. Grip strength measurements were taken using a standard
Jamar dynamometer and 2 custom-designed tools for cylindrical grasp and pinch strength.
Results
Twenty-three subjects were enrolled, with a total of 32 thumbs measured: 15 thumbs
with arthritis and 17 healthy thumbs. Multivariable logistic regression models indicated
that thumbs with thicker OPP had 0.85 lower odds (95% CI = 0.71–0.97) of early OA,
adjusting for hand dominance and the first metacarpal length. Linear regression models
indicated no association between early OA and grip strength.
Conclusions
The size of OPP may have a weak association with the diagnosis of early OA.
Clinical relevance
This study supports further exploration of the role of OPP in stabilizing the CMC
joint, particularly with regard to minimizing joint subluxation. This may be clinically
relevant to providers who treat patients with CMC OA early in the course of the disease,
when nonsurgical treatment is the most relevant.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Thumb basal joint arthritis.Clin Plast Surg. 2019; 46: 407-413
- Imaging and management of thumb carpometacarpal joint osteoarthritis.Skeletal Radiol. 2015; 44: 165-177
- Trapeziometacarpal joint stability: the evolving importance of the dorsal ligaments.Clin Orthop Relat Res. 2014; 472: 1138-1145
- Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology.J Bone Joint Surg Am. 2012; 94: 1468-1477
- The 2014 ABJS Nicolas Andry Award: the puzzle of the thumb: mobility, stability, and demands in opposition.Clin Orthop Relat Res. 2014; 472: 3605-3622
- Reduction in cylindrical grasp strength is associated with early thumb carpometacarpal osteoarthritis.Clin Orthop Relat Res. 2017; 475: 522-528
- Intra- and interobserver reliability of the Eaton classification for trapeziometacarpal arthritis: a systematic review.Clin Orthop Relat Res. 2014; 472: 1155-1159
- Ultrasonographic quantification of intrinsic hand muscle cross-sectional area; reliability and validity for predicting muscle strength.Arch Phys Med Rehabil. 2015; 96: 845-853
- Associations between handgrip strength and ultrasound-measured muscle thickness of the hand and forearm in young men and women.Ultrasound Med Biol. 2015; 41: 2125-2130
- Morphological and functional relationships with ultrasound measured muscle thickness of the upper extremity and trunk.Ultrasound. 2014; 22: 229-235
- Weaker functional pinch strength is associated with early thumb carpometacarpal osteoarthritis.Clin Orthop Relat Res. 2016; 474: 557-561
- Evaluation of physical examination tests for thumb basal joint osteoarthritis.Hand. 2016; 11: 108-112
- The diagnostic clinical value of thumb metacarpal grind, pressure-shear, flexion, and extension tests for carpometacarpal osteoarthritis.J Hand Ther. 2019; 32: 35-40
- Correlation of clinical disease severity to radiographic thumb osteoarthritis index.J Hand Surg Am. 2015; 40: 474-482
- Estimating the volume of the first dorsal interossoeus using ultrasound.Med Eng Phys. 2011; 33: 391-394
- Quantitative muscle ultrasonography in carpal tunnel syndrome.Ann Rehabil Med. 2016; 40: 1048-1056
- Radiographic analysis of simulated first dorsal interosseous and opponens pollicis loading upon thumb CMC joint subluxation: a cadaver study.Hand. 2018; 13: 40-44
- Quantification of dexterity as the dynamical regulation of instabilities: comparisons across gender, age, and disease.Front Neurol. 2014; 15: 53
- The strength-dexterity test as a measure of dynamic pinch performance.J Biomech. 2003; 36: 265-270
- Early osteoarthritis of the trapeziometacarpal joint is not associated with joint instability during typical isometric loading.J Orthop Res. 2015; 33: 1639-1645
Article info
Publication history
Published online: September 08, 2021
Accepted:
July 21,
2021
Received:
June 3,
2020
Footnotes
This research was supported by grants from the MedScholars program at Stanford School of Medicine, and the Williams Foundation.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
