Topography of the osteoarthritic thumb carpometacarpal joint and its variations with regard to gender, age, site, and osteoarthritic stage

The articular topography of 46 osteoarthritic thumb carpometacarpal joints was quantitatively analyzed, as well as variations with regard to gender, age, site, and anatomic osteoarthritic stage. It was found that for osteoarthritic thumb carpometacarpal joints, (1) the opposing articular surfaces of elder and severely degenerated joints are more congruent than those of middle-aged and minimally or moderately degenerated joints, although the articular contact area is not significantly different when accounting for thinning of the cartilage layer with age or disease; (2) significant changes in joint topography due to osteoarthritis only occur in severely degenerated joints; (3) joints in women are less congruent, have smaller contact areas, and are likely to experience higher contact stresses than joints in men for similar activities of daily living that involve similar joint loads; and (4) osteoarthritic changes are less severe on the dorsoulnar aspect of the trapezium and the dorsal aspect of the metacarpal, which are known to be low load-bearing regions. (C) 1998 by the American Society for Surgery of the Hand.