Trapeziometacarpal joint mobility in gibbons (fam. Hylobatidae) and rhesus macaques (Macaca mulatta).

OBJECTIVES: The purpose of this study is to investigate the differences in 3D kinematics of the trapeziometacarpal (TMC) joint between gibbons (fam. Hylobatidae) and macaques (Macaca mulatta), two non-human primate groups with a distinct locomotor behavior. Gibbons are highly arboreal species, while macaques are quadrupeds. Here, we investigate the mobility and structural constraints of the TMC joint in both these primates and evaluate the hypothesis that differences in locomotor mode are reflected in joint structure and function. MATERIALS AND METHODS: We have developed an innovative software suite allowing for the quantification of in situ 3D kinematics based on medical imaging of the primate TMC joint using a unique sample of eight gibbons and seven macaques. These analyses are further supported by detailed dissection of the surrounding ligaments. RESULTS: The data demonstrate distinct differences in TMC joint mobility between gibbons and macaques, with wide ranges of motion in the gibbon TMC joint and restricted movement in macaques. Furthermore, the dissections show little dissimilarity in ligament anatomy that could be associated with the differences in TMC joint capabilities. CONCLUSION: We conclude that gibbons possess a highly mobile TMC joint and the ball-and-socket morphology allows for large ranges of motion. This type of morphology, however, does not offer much inherent stabilization. Lack of structural joint reinforcement suggests that gibbons may have difficulty in performing any type of power grasp with high loads. Macaques, on the other hand, are shown to have a considerably reinforced TMC joint, which is likely related to the habitual loading of the thumb during locomotion.

The effect of orthoses on the kinematics of the trapeziometacarpal, scaphotrapeziotrapezoidal, and radioscaphoid joints.

The in vivo effect of four different types of thumb and thumb-wrist orthoses on the three-dimensional kinematics of the trapeziometacarpal (TMC), scaphotrapeziotrapezoidal (STT) and radioscaphoid joints was quantified using computed tomography (CT). Eighteen healthy female volunteers were recruited. The dominant hand of each subject was scanned in four thumb and wrist positions, each in three conditions: without orthosis, with a thumb orthosis (Push Ortho and immediate fitting, IMF) and with a thumb-wrist orthosis (Ligaflex Manu and IMF). CT images were analyzed and rotations relative to the more proximal bone were expressed in a joint-specific coordinate system. Without orthosis, the largest STT rotations were observed during radioulnar deviation of the wrist and the STT range of motion (ROM) was significantly lower during wrist flexion-extension. All tested orthoses caused a significant reduction of the ROM at each joint compared to free motion. Significant differences in movement reduction were observed between prefabricated and IMF orthoses.The IMF thumb-wrist outperformed the Ligaflex Manu in terms of immobilization of the radioscaphoid joint. In addition, the IMF thumb orthosis immobilized the TMC joint significantly better during thumb abduction and adduction than the Push Ortho. We found that different types of thumb and thumb-wrist orthotics are effective in reducing joint mobility. While this reduction tends to be higher using IMF compared to prefabricated orthoses, this effect is only significant for the radioscaphoid and TMC joint. The finding that thumb movements do not induce large STT rotations suggests that the thumb does not need to be immobilized in case of isolated STT osteoarthritis.

Trapeziometacarpal stabilization through dorsoradial ligament reconstruction: An early post-surgery in vivo biomechanical analyses.

Ligament reconstruction can provide pain relief in patients with a painful, unstable, pre-arthritic trapeziometacarpal (TMC) joint. Imbrication of the dorsoradial ligament (DRL) has been proposed as a minimal invasive stabilization technique. It requires less invasive surgery than an Eaton-Littler technique and shows promising long-term clinical outcome. We used dynamic CT to objectively review the effects of the imbrication. Four patients with pain and laxity at the TMC joint, but without radiographic signs of osteoarthritis, were recruited. Dynamic CT scans were made during active thumb abduction-adduction, flexion-extension, and two functional grip tasks using a radiolucent jig. Scans of the patients were acquired before and 3 to 6 months after DRL reconstruction. Motion of each bone in the articular chain of the thumb was quantified. In addition, we mapped changes in the contact patterns between the articular facets during the entire thumb motion. After DRL imbrication, we found no overall decrease in MC1 movement in three out of four patients. Furthermore, no increase in TMC joint congruency, defined as proximity area size, was found for three out of four patients. Pre- and post-operative differences in congruency across different tasks were patient-dependent and relatively small. We demonstrated that, from a biomechanical perspective, there is high variability in post-operative outcome between patients that undergo identical surgical procedures performed by the same surgeon. A post-operative decrease in range of motion, increase in joint congruency or decrease in proximity area shift during thumb motion is not omnipresent. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2851-2864, 2018.