Kinematics of the trapeziometacarpal joint: A biomechanical analysis comparing tendon interposition arthroplasty and total-joint arthroplasty

被引:46
作者
Imaeda, T [1 ]
Cooney, WP [1 ]
Niebur, GL [1 ]
Linscheid, RL [1 ]
An, KN [1 ]
机构
[1] MAYO CLIN & MAYO FDN, DIV ORTHOPED RES, ROCHESTER, MN 55905 USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 1996年 / 21A卷 / 04期
关键词
D O I
10.1016/S0363-5023(96)80002-5
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The kinematics of the trapeziometacarpal joint were studied in 15 cadaver hands; normal joints were compared with simulated arthroplasties-either a total-joint arthroplasty of the ball-and-socket variety or a fibrous suspension arthroplasty of ligament reconstruction with tendon interposition. The motion of the thumb metacarpal was analyzed based on a trapezial coordinate system, using a magnetic tracking system. The pivot point (instantaneous center of rotation) for the thumb metacarpal changed during active and passive circumduction. Compared with normal trapeziometacarpal joint motion, the pivot point after ligament reconstruction with tendon interposition shifted significantly in palmar and ulnar directions in reference to the trapezial coordinate system, whereas after total-joint arthroplasty, the pivot point shifted slightly palmarly and radially. The axes of rotation were also compared for ligament reconstruction with tendon interposition and total-joint arthroplasty during thumb flexion-extension and abduction-adduction motions. After ligament reconstruction with tendon interposition, the center of flexion-extension shifted palmarly and the center of abduction-adduction shifted ulnarly. After total-joint arthroplasty, the center of rotation For flexion-extension shifted distally and palmarly and that for abduction-adduction shifted palmarly and proximally. in comparison with the normal joint, passive circumduction increased after tendon interposition arthroplasty but was less with total-joint arthroplasty. Changes in kinematics suggest a suspensory ligament function of ligament reconstruction with tendon interposition arthroplasty, whereas total-joint arthroplasty results in axes of rotation that reflect the joint replacement rather those of the normal joint.
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页码:544 / 553
页数:10
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