Abstract

The basilar thumb joint is the joint second most commonly affected by osteoarthritis (OA) in the hand. Evaluation of dorsal subluxation of the thumb during a functional task such as key pinch could help assess OA risk. The objectives of this study were to determine the best imaging angle for measuring thumb dorsal subluxation during key pinch and to compare subluxation to corresponding OA grades on the Eaton–Glickel, Outerbridge, and International Cartilage Repair Society scales. Eleven cadaveric forearm specimens were rigged to simulate key pinch. A mobile c-arm captured anteroposterior (AP) view images of the hand and was rotated in 5 deg increments toward the ulnar aspect of the arm up to 60 deg. Dorsal subluxation was measured on each image and compared to determine which angle captured maximum subluxation. The resulting best imaging angle was used for comparisons between dorsal subluxation of the thumb and OA grades for the basilar thumb joint. The max subluxation was in the AP view for most specimens. There was a significant correlation between subluxation and the Eaton–Glickel grade (p =0.003, R2 = 0.779), but not with either Outerbridge grades (p =0.8018) or International Cartilage Repair Society grades (p =0.7001). Our results indicate that dorsal thumb subluxation during key pinch should be measured in the AP view of the forearm/hand. Dorsal thumb subluxation during key pinch had a significant correlation with the Eaton–Glickel radiographic measure of OA but not with more accurate visual classifications of OA.

References

1.
Dahaghin
,
S.
,
Bierma-Zeinstra
,
S. M.
,
Ginai
,
A. Z.
,
Pols
,
H. A.
,
Hazes
,
J. M.
, and
Koes
,
B. W.
,
2005
, “
Prevalence and Pattern of Radiographic Hand Osteoarthritis and Association With Pain and Disability (the Rotterdam Study)
,”
Ann. Rheum. Dis.
,
64
(
5
), pp.
682
687
.10.1136/ard.2004.023564
2.
Wilder
,
F. V.
,
Barrett
,
J. P.
, and
Farina
,
E. J.
,
2006
, “
Joint-Specific Prevalence of Osteoarthritis of the Hand
,”
Osteoarthritis Cartilage
,
14
(
9
), pp.
953
957
.10.1016/j.joca.2006.04.013
3.
Pelligrini
,
V. D.
, Jr.
,
1991
, “
Osteoarthritis of the Trapeziometacarpal Joint: The Pathophysiology of Articular Cartilage Degeneration. II. Articular Wear Patterns in the Osteoarthritic Joint
,”
J. Hand Surg. Am.
,
16
(
6
), pp.
975
982
.10.1016/S0363-5023(10)80055-3
4.
Pellegrini
,
V. D.
, Jr.
,
1991
, “
Osteoarthritis of the Trapeziometacarpal Joint: The Pathophysiology of Articular Cartilage Degeneration. I. Anatomy and Pathology of the Aging Joint
,”
J. Hand Surg. Am.
,
16
(
6
), pp.
967
974
.10.1016/S0363-5023(10)80054-1
5.
Jonsson
,
H.
,
Valtysdottir
,
S. T.
,
Kjartansson
,
O.
, and
Brekkan
,
A.
,
1996
, “
Hypermobility Associated With Osteoarthritis of the Thumb Base: A Clinical and Radiological Subset of Hand Osteoarthritis
,”
Ann. Rheum. Dis.
,
55
(
8
), pp.
540
543
.10.1136/ard.55.8.540
6.
Eaton
,
R. G.
, and
Littler
,
J. W.
,
1973
, “
Ligament Reconstruction for the Painful Thumb Carpometacarpal Joint
,”
J. Bone Jt. Surg. Am.
,
55
(
8
), pp.
1655
1666
.10.2106/00004623-197355080-00010
7.
Eaton
,
R. G.
, and
Glickel
,
S. Z.
,
1987
, “
Trapeziometacarpal Osteoarthritis. Staging as a Rationale for Treatment
,”
Hand Clin.
,
3
(
4
), pp.
455
471
.10.1016/S0749-0712(21)00761-7
8.
Becker
,
S. J. E.
,
Bruinsma
,
W. E.
,
Guitton
,
T. G.
,
van der Horst
,
C. M. A. M.
,
Strackee
,
S. D.
,
Ring
,
D.
,
Abdel-Ghany
,
M. I.
,
Abzug
,
J. M.
,
Adams
,
J.
,
Akabudike
,
N. M.
,
Apard
,
T.
,
Bainbridge
,
L. C.
,
Bamberger
,
H. B.
,
Baratz
,
M.
,
Romero Barreto
,
C. J.
,
Baxamusa
,
T.
,
de Bedout
,
R.
,
Beldner
,
S.
,
Benhaim
,
P.
,
Blazar
,
P.
,
Boyer
,
M.
,
Calcagni
,
M.
,
Calfee
,
R. P.
,
Capo
,
J. T.
,
Cassidy
,
C.
,
Catalano
,
L.
,
Chivers
,
K.
,
DeSilva
,
G.
,
Dodds
,
S.
,
Edelstein
,
D. M.
,
Erickson
,
J. M.
,
Evans
,
P. J.
,
Fernandes
,
C. H.
,
Gaston
,
R. G.
,
Gilbert
,
R. S.
,
Grafe
,
M. W.
,
Gray
,
R. R. L.
,
Grunwald
,
H. W.
,
Gutow
,
A. P.
,
Hahn
,
P.
,
Hammert
,
W. C.
,
Hauck
,
R.
,
Hilliard
,
S. M.
,
Hofmeister
,
E.
,
Huang
,
J. I.
,
Hutchison
,
R. L.
,
Ilyas
,
A.
,
Jacoby
,
S. M.
,
Jebson
,
P.
,
Jones
,
C. M.
,
Kalainov
,
D. M.
,
Kaplan
,
F. T. D.
,
Kaplan
,
S.
,
Kennedy
,
S. A.
,
Kessler
,
M. W.
,
Klinefelter
,
R.
,
Ko
,
J. H.
,
Kraan
,
G. A.
,
Kronlage
,
S.
,
Ladd
,
A.
,
Lane
,
L. B.
,
Lee
,
K.
,
Martineau
,
P. A.
,
McAuliffe
,
J.
,
Merrell
,
G.
,
van Minnen
,
L. P.
,
Oliveira Miranda
,
C. D.
,
Moreno-Serrano
,
C. L.
,
Nancollas
,
M.
,
Naquira Escobar
,
L. F.
,
Osei
,
D. A.
,
Owens
,
P. W.
,
Palmer
,
B. A.
,
Palmer
,
M. J.
,
Polatsch
,
D.
,
Rizzo
,
M.
,
Rodner
,
C.
,
Rozental
,
T. D.
,
Ruchelsman
,
D.
,
Rumball
,
K. M.
,
Semenkin
,
O. M.
,
Shatford
,
R.
,
Siff
,
T.
,
Slater
,
R. R.
,
Soong
,
M.
,
Spruijt
,
S.
,
Suarez
,
F.
,
Swigart
,
C.
,
Taras
,
J.
,
Terrono
,
A. L.
,
Varecka
,
T. F.
,
Walbeehm
,
E. T.
,
Walter
,
F. L.
,
Weiss
,
L.
,
Wills
,
B. P. D.
,
Wint
,
J.
,
Wolf
,
J. M.
, and
Wyrick
,
T.
,
2016
, “
Interobserver Agreement of the Eaton-Glickel Classification for Trapeziometacarpal and Scaphotrapezial Arthrosis
,”
J. Hand Surg. Am.
,
41
(
4
), pp.
532
540
.10.1016/j.jhsa.2015.12.028
9.
Choa
,
R. M.
, and
Giele
,
H. P.
,
2015
, “
Inter- and Intrarater Reliability of Osteoarthritis Classification at the Trapeziometacarpal Joint
,”
J. Hand Surg. Am.
,
40
(
1
), pp.
23
26
.10.1016/j.jhsa.2014.09.007
10.
Dela Rosa
,
T. L.
,
Vance
,
M. C.
, and
Stern
,
P. J.
,
2004
, “
Radiographic Optimization of the Eaton Classification
,”
J. Hand Surg. Br.
,
29
(
2
), pp.
173
177
.10.1016/j.jhsb.2003.09.003
11.
Kubik
,
N. J.
, 3rd
, and
Lubahn
,
J. D.
,
2002
, “
Intrarater and Interrater Reliability of the Eaton Classification of Basal Joint Arthritis
,”
J. Hand Surg. Am.
,
27
(
5
), pp.
882
885
.10.1053/jhsu.2002.35310
12.
Badia
,
A.
,
2007
, “
Arthroscopy of the Trapeziometacarpal and Metacarpophalangeal Joints
,”
J. Hand Surg. Am.
,
32
(
5
), pp.
707
24
.10.1016/j.jhsa.2007.02.020
13.
Berger
,
R. A.
,
1997
, “
A Technique for Arthroscopic Evaluation of the First Carpometacarpal Joint
,”
J. Hand Surg. Am.
,
22
(
6
), pp.
1077
1080
.10.1016/S0363-5023(97)80052-4
14.
Wolf
,
J. M.
,
Oren
,
T. W.
,
Ferguson
,
B.
,
Williams
,
A.
, and
Petersen
,
B.
,
2009
, “
The Carpometacarpal Stress View Radiograph in the Evaluation of Trapeziometacarpal Joint Laxity
,”
J. Hand Surg. Am.
,
34
(
8
), pp.
1402
1406
.10.1016/j.jhsa.2009.06.030
15.
Wolf
,
J. M.
,
Schreier
,
S.
,
Tomsick
,
S.
,
Williams
,
A.
, and
Petersen
,
B.
,
2011
, “
Radiographic Laxity of the Trapeziometacarpal Joint is Correlated With Generalized Joint Hypermobility
,”
J. Hand Surg. Am.
,
36
(
7
), pp.
1165
1169
.10.1016/j.jhsa.2011.03.017
16.
Halilaj
,
E.
,
Moore
,
D. C.
,
Patel
,
T. K.
,
Ladd
,
A. L.
,
Weiss
,
A. P.
, and
Crisco
,
J. J.
,
2015
, “
Early Osteoarthritis of the Trapeziometacarpal Joint is Not Associated With Joint Instability During Typical Isometric Loading
,”
J. Orthop. Res.
,
33
(
11
), pp.
1639
1645
.10.1002/jor.22936
17.
Pellegrini
,
V. D.
, Jr.
,
Olcott
,
C. W.
, and
Hollenberg
,
G.
,
1993
, “
Contact Patterns in the Trapeziometacarpal Joint: The Role of the Palmar Beak Ligament
,”
J. Hand Surg. Am.
,
18
(
2
), pp.
238
244
.10.1016/0363-5023(93)90354-6
18.
Riordan
,
E.
,
Robbins
,
S.
Deveza
,
L.
,
Duong
,
V.
,
Oo
,
W.
,
Wajon
,
M.
,
Bennell
,
A.
,
Eyles
,
K.
,
Jongs
,
J.
,
Linklater
,
R. J.
, and
Hunter
,
D.
,
2018
, “
Radial Subluxation in Relation to Hand Strength and Radiographic Severity in Trapeziometacarpal Osteoarthritis
,”
Osteoarthritis Cartilage
,
26
(
11
), pp.
1506
1510
.10.1016/j.joca.2018.06.014
19.
Adams
,
J. E.
,
O'Brien
,
V.
,
Magnusson
,
E.
,
Rosenstein
,
B.
, and
Nuckley
,
D. J.
,
2018
, “
Radiographic Analysis of Simulated First Dorsal Interosseous and Opponens Pollicis Loading Upon Thumb CMC Joint Subluxation: A Cadaver Study
,”
Hand (NY)
,
13
(
1
), pp.
40
44
.10.1177/1558944717691132
20.
Cheema
,
T.
,
Salas
,
C.
,
Morrell
,
N.
,
Lansing
,
L.
,
Reda Taha
,
M. M.
, and
Mercer
,
D.
,
2012
, “
Opening Wedge Trapezial Osteotomy as Possible Treatment for Early Trapeziometacarpal Osteoarthritis: A Biomechanical Investigation of Radial Subluxation, Contact Area, and Contact Pressure
,”
J. Hand Surg. Am.
,
37
(
4
), pp.
699
705
.10.1016/j.jhsa.2012.01.013
21.
Tomaino
,
M. M.
,
Pellegrini
,
V. D.
, Jr.
, and
Burton
,
R. I.
,
1995
, “
Arthroplasty of the Basal Joint of the Thumb. Long-Term Follow-Up After Ligament Reconstruction With Tendon Interposition
,”
J. Bone Jt. Surg. Am.
,
77
(
3
), pp.
346
355
.10.2106/00004623-199503000-00003
22.
Clancey
,
G. J.
,
1989
, “
Radiograph Assessment of the Basal Thumb Joint
,”
Orthop. Nurs.
,
8
(
4
), pp.
58
–5
9
.10.1097/00006416-198907000-00021
23.
Brown
,
G. D.
, 3rd
,
Roh
,
M. S.
,
Strauch
,
R. J.
,
Rosenwasser
,
M. P.
,
Ateshian
,
G. A.
, and
Mow
,
V. C.
,
2003
, “
Radiography and Visual Pathology of the Osteoarthritic Scaphotrapezio-Trapezoidal Joint, and Its Relationship to Trapeziometacarpal Osteoarthritis
,”
J. Hand Surg. Am.
,
28
(
5
), pp.
739
43
.10.1016/S0363-5023(03)00258-2
24.
North
,
E. R.
, and
Eaton
,
R. G.
,
1983
, “
Degenerative Joint Disease of the Trapezium: A Comparative Radiographic and Anatomic Study
,”
J. Hand Surg. Am.
,
8
(
2
), pp.
160
166
.10.1016/S0363-5023(83)80008-2
25.
Glickel
,
S. Z.
,
Kornstein
,
A. N.
, and
Eaton
,
R. G.
,
1992
, “
Long-Term Follow-Up of Trapeziometacarpal Arthroplasty With Coexisting Scaphotrapezial Disease
,”
J. Hand Surg. Am.
,
17
(
4
), pp.
612
620
.10.1016/0363-5023(92)90303-7
26.
Halilaj
,
E.
,
Rainbow
,
M. J.
,
Moore
,
D. C.
,
Laidlaw
,
D. H.
,
Weiss
,
A. P.
,
Ladd
,
A. L.
, and
Crisco
,
J. J.
,
2015
, “
In Vivo Recruitment Patterns in the Anterior Oblique and Dorsoradial Ligaments of the First Carpometacarpal Joint
,”
J. Biomech.
,
48
(
10
), pp.
1893
1898
.10.1016/j.jbiomech.2015.04.028
27.
Imaeda
,
T.
,
Niebur
,
G.
,
Cooney
,
W. P.
,
Linscheid
,
R. L.
, and
An
,
K.-N.
,
1997
, “
Ligament Length During Circumduction of the Trapeziometacarpal Joint
,”
J. Orthop. Sci.
,
2
(
5
), pp.
319
327
.10.1007/BF02488916
28.
Spaans
,
A. J.
,
van Laarhoven
,
C. M.
,
Schuurman
,
A. H.
, and
van Minnen
,
L. P.
,
2011
, “
Interobserver Agreement of the Eaton-Littler Classification System and Treatment Strategy of Thumb Carpometacarpal Joint Osteoarthritis
,”
J. Hand Surg. Am.
,
36
(
9
), pp.
1467
1470
.10.1016/j.jhsa.2011.06.017
29.
Hansen
,
T. B.
,
Sorensen
,
O. G.
,
Kirkeby
,
L.
,
Homilius
,
M.
, and
Amstrup
,
A. L.
,
2013
, “
Computed Tomography Improves Intra-Observer Reliability, but Not the Inter-Observer Reliability of the Eaton-Glickel Classification
,”
J. Hand Surg. Eur..
38
(
2
), pp.
187
191
.10.1177/1753193412443502
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