The human first carpometacarpal joint: osteoarthritic degeneration and 3-dimensional modeling

Abstract

The purpose of this study was to gain insight into potential mechanical factors contributing to osteoarthritis of the human first carpometacarpal joint (CMC). This was accomplished by creating three-dimensional (3-D) computer models of the articular surfaces of CMC joints of older humans and by determining their locus of cartilage degeneration. The research questions of this study were: 1) What is the articular wear pattern of cartilage degeneration in CMC osteoarthritis?, (2) Are there significant topographic differences in joint area and contour between the joints of males and females?, and 3) Are there measurable bony joint recesses consistently found within the joint? The articular surfaces of 25 embalmed cadaveric joints (from 13 cadavers) were graded for degree of osteoarthritis, and the location of degeneration was mapped using a dissection microscope. The surfaces of 14 mildly degenerated joints were digitized and reconstructed as 3-D computer models using the Microscribe 3D-X Digitizer and the Rhinoceros 2.0 NURBS Modeling Software. This technology provided accurate and reproducible information on joint area and topography. The dorsoradial trapezial region was found to be significantly more degenerated than other quadrants in both males and females. Mean trapezial articular surface area was 197 mm 2 in males and 160 mm(2) in females; the respective mean areas for the metacarpal were 239 mm(2) in males and 184 mm(2) in females. Joints of females were found to be significantly more concave in radioulnar profile than those of males. Three bony joint recesses were consistently found, two in the radial and ulnar aspects of the trapezium and the third in the palmar surface of the metacarpal.