Carpometacarpal joint morphological changes associated with decreased strength over time
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Grip, key and tip pinch strength was reduced during 6-year follow-up in patients with carpometacarpal joint changes, osteoarthritis and volar beak recession, results presented at the Orthopaedic Research Society Annual Meeting showed.
Edgar Garcia-Lopez, a biomechanics research intern at University Orthopedics in Providence, Rhode Island, said in his presentation, “In this study, we saw that strength decreased with volar beak recession or increased bony recession was associated with decreased strength as measured by grip, key and tip pinch over the 6 years. The volar beak region of the [carpometacarpal] CMC joint is a location of focused physical stresses and biological changes that may be one of the factors that affect strength.”
As CMC joint OA increases, function tends to decrease in the joint and osteophytes, pain and other problems may develop, according to Garcia-Lopez.
To determine whether there was an association between changes in CMC joint morphology and first metacarpal (MC1) volar beak recession and strength measures of the thumb, Garcia-Lopez and colleagues studied 90 patients (47 women, 43 men) aged 45 to 75 years with stage 0 to 1 OA of the CMC joint. Patients underwent various evaluations of their CMC joint, as well as plain radiographs and CT scans at baseline and 1.5, 3, 4.5 and 6 years follow-up.
Researchers created models of patients’ CMC joints at each follow-up to analyze any volar beak regression that was present.
They saw that with increased volar beak recession, statistically significant decreases occurred in grip measured with a Jamar dynamometer, as well as in key pinch and tip pinch.
“Strength measures change from enrollment was significant at years 1.5, 3, 4.5 and 6 for all strength measures. When comparing grip strength to volar beak recession, we saw that it increased over the 6 years and this relationship was significant. Key pinch had a similar pattern and so did tip pinch, where tip pinch decreased as volar beak recession increased over the 6 years,” Garcia-Lopez said.
Quantifying MC1 volar beak recession may be a useful marker to assess disease progression in patients who are in the early stages of CMC OA, researchers noted.
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