Osteoarthritis of the trapeziometacarpal joint: The pathophysiology of articular cartilage degeneration. II. Articular wear patterns in the osteoarthritic joint

The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition

“…The expansile dish pattern, in contrast, had significant rimming osteophytes and loose bodies. Surgical inspection did not reveal metacarpal dysmorphology with the dish pattern, other than extrinsic osteophytes and joint eburnation in the cases of dysplastic dish shape, similar to other reports [79,80,86,107]. This is unlike posttraumatic arthritis of a Rolando fracture, where the metacarpal is fractured and becomes dysplastic yet typically the trapezial shape is unaltered.…”

“…Conversely, the volar ligaments are thin, capsular structures, variable in location, with thenar muscles intimal to their presence. Whereas many investigators emphasize importance of the anterior oblique ''beak'' ligament in the presence and creation of arthritis [32][33][34][35][85][86][87][88][89], our studies have focused on normal anatomy analysis, which may in part address this discrepancy. The volar ligaments were lacking in normal ligamentous structure and also mechanoreceptor innervation.…”

“…The literature varies on reported load patterns in trapezial arthritis [3,4,32,53,54,86,89], with volar wear predominating [86,87,89,107].…”

Microstructural adaptation in trapezial bone due to subluxation of the thumb

“…41 We expected the most pronounced bone reaction to be in the central region of the osteoarthritic trapezia according to his work.…”

Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

“…Arthritis of this joint more commonly occurs in women than in men, starting in middle adulthood and increasing in prevalence with age [14]; radiographic prevalence ranging from 33% of postmenopausal women [1] to as high as 100% of women older than 91 years is described [4]. The anterior oblique ligament incompetence has been shown to play a role in the progression of CMC arthritis [3,7,19,20].…”