Joint Kinematics After Thumb Carpometacarpal Joint Reconstruction: An In Vitro Comparison of Various Constructs

Matthew F. Koff, Kristin D. Zhao, Cay M. Mierisch, Meng-Yi Chen, Kai-Nan An and William P. Cooney

The purpose of this study was to evaluate kinematic changes of the thumb CMC joint as the result of different thumb reconstruction procedures.  Fifteen cadaveric forearms were prepared and instrumented with an electromagnetic tracking device to measure the motion of the thumb metacarpal with respect to the trapezium. Kinematics of the intact thumb and the thumb after trapeziectomy under passive motion were recorded. Specimens then had joint reconstruction consisting of either a ligament reconstruction with tendon interposition (LRTI), Weilby arthroplasty, or Thompson arthroplasty.  The results showed that the type of surgical treatment significantly affected the joint radius of motion and the 3D work area.  Only the LRTI reconstruction produced a joint radius of motion and a 3D work area similar to the those of an intact thumb. The authors conclude that additional research is needed to define the optimal surgical techniques to treat the end-stage OA thumb CMC joint.

The Journal of Hand Surgery, Volume 32, Issue 5, May-June 2007, Pages 688-696

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