The effect of surgical treatments for trapeziometacarpal osteoarthritis on wrist biomechanics: a cadaver study
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Published version
Author(s)
Shah, Darshan
Middleton, Claire
Gurdezi, Sabahat
Horwitz, Maxim
Kedgley, Angela
Type
Journal Article
Abstract
Purpose: Studies have shown the effects of surgical treatments for trapeziometacarpal osteoarthritis on thumb biomechanics; however, the biomechanical effects on the wrist have not been reported. This study aimed to quantifyalterations in wrist muscle forces following trapeziectomy with or withoutligament reconstruction and replacement. Methods: A validated physiological wrist simulator replicatedcyclic wrist motions in cadaveric specimens by applying tensile loads to six muscles. Muscle forces required to move the intact wrist were compared to those required after performing trapeziectomy, suture suspension arthroplasty, prosthetic replacement and ligament reconstruction with tendon interposition (LRTI). Results: Trapeziectomy requiredhigher abductor pollicis longusforcesinflexion, and higher flex or carpi radialis forces coupled with lower extensor carpi ulnaris forces in radial deviation. Of the three surgical reconstructions tested post-trapeziectomy, wrist muscle forces following LRTI were closest to those observed in the intact case, throughout the range of all simulated motions. Conclusions: This study shows that wrist biomechanics weresignificantly altered following trapeziectomy, and of the reconstructions tested, LRTI most closely resembled the intact biomechanics in this cadaveric model.
Date Issued
2020-05-01
Date Acceptance
2019-10-08
Citation
Journal of Hand Surgery (American Volume), 2020, 45 (5), pp.389-398
ISSN
0363-5023
Publisher
Elsevier
Start Page
389
End Page
398
Journal / Book Title
Journal of Hand Surgery (American Volume)
Volume
45
Issue
5
Copyright Statement
© 2020by the American Society for Surgery of the Hand. Published by Elsevier Inc.This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Sponsor
Arthritis Research UK
The Royal Society
Grant Number
20556
RG130400
Subjects
LRTI
arthroplasty
simulator
trapeziectomy
trapeziometacarpal osteoarthritis
1103 Clinical Sciences
Orthopedics
Publication Status
Published
Date Publish Online
2019-11-14