The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition
Identifieur interne : 003258 ( Ncbi/Merge ); précédent : 003257; suivant : 003259The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition
Auteurs : Amy L. Ladd [États-Unis] ; Joseph J. Crisco [États-Unis] ; Elisabet Hagert [Suède] ; Jessica Rose [États-Unis] ; Arnold-Peter C. Weiss [États-Unis]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2014.
Abstract
The paradoxical demands of stability and mobility reflect the purpose and function of the human thumb. Its functional importance is underscored when a thumb is congenitally absent, injured, or afflicted with degenerative arthritis. Prevailing literature and teaching implicate the unique shape of the thumb carpometacarpal (CMC) joint, as well as its ligament support, applied forces, and repetitive motion, as culprits causing osteoarthritis (OA). Sex, ethnicity, and occupation may predispose individuals to OA.
What evidence links ligament structure, forces, and motion to progressive CMC disease? Specifically: (1) Do unique attributes of the bony and ligamentous anatomy contribute to OA? (2) Can discrete joint load patterns be established that contribute to OA? And (3) can thumb motion that characterizes OA be measured at the fine and gross level?
We addressed the morphology, load, and movement of the human thumb, emphasizing the CMC joint in normal and arthritic states. We present comparative anatomy, gross dissections, microscopic analysis, multimodal imaging, and live-subject kinematic studies to support or challenge the current understanding of the thumb CMC joint and its predisposition to disease.
The current evidence suggests structural differences and loading characteristics predispose the thumb CMC to joint degeneration, especially related to volar or central wear. The patterns of degeneration, however, are not consistently identified, suggesting influences beyond inherent anatomy, repetitive load, and abnormal motion.
Additional studies to define patterns of normal use and wear will provide data to better characterize CMC OA and opportunities for tailored treatment, including prevention, delay of progression, and joint arthroplasty.
The online version of this article (doi:10.1007/s11999-014-3901-6) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s11999-014-3901-6
PubMed: 25171934
PubMed Central: 4397810
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<author><name sortKey="Ladd, Amy L" sort="Ladd, Amy L" uniqKey="Ladd A" first="Amy L." last="Ladd">Amy L. Ladd</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Stanford University, Chase Hand Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304 USA</nlm:aff>
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<wicri:cityArea>Department of Orthopaedic Surgery, Stanford University, Chase Hand Center, 770 Welch Road, Suite 400, Palo Alto</wicri:cityArea>
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<author><name sortKey="Crisco, Joseph J" sort="Crisco, Joseph J" uniqKey="Crisco J" first="Joseph J." last="Crisco">Joseph J. Crisco</name>
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<country>États-Unis</country>
<placeName><region type="state">Rhode Island</region>
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<country>États-Unis</country>
<placeName><region type="state">Californie</region>
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<author><name sortKey="Weiss, Arnold Peter C" sort="Weiss, Arnold Peter C" uniqKey="Weiss A" first="Arnold-Peter C." last="Weiss">Arnold-Peter C. Weiss</name>
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<series><title level="j">Clinical Orthopaedics and Related Research</title>
<idno type="ISSN">0009-921X</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The paradoxical demands of stability and mobility reflect the purpose and function of the human thumb. Its functional importance is underscored when a thumb is congenitally absent, injured, or afflicted with degenerative arthritis. Prevailing literature and teaching implicate the unique shape of the thumb carpometacarpal (CMC) joint, as well as its ligament support, applied forces, and repetitive motion, as culprits causing osteoarthritis (OA). Sex, ethnicity, and occupation may predispose individuals to OA.</p>
</sec>
<sec><title>Questions/purposes</title>
<p>What evidence links ligament structure, forces, and motion to progressive CMC disease? Specifically: (1) Do unique attributes of the bony and ligamentous anatomy contribute to OA? (2) Can discrete joint load patterns be established that contribute to OA? And (3) can thumb motion that characterizes OA be measured at the fine and gross level?</p>
</sec>
<sec><title>Methods</title>
<p>We addressed the morphology, load, and movement of the human thumb, emphasizing the CMC joint in normal and arthritic states. We present comparative anatomy, gross dissections, microscopic analysis, multimodal imaging, and live-subject kinematic studies to support or challenge the current understanding of the thumb CMC joint and its predisposition to disease.</p>
</sec>
<sec><title>Results</title>
<p>The current evidence suggests structural differences and loading characteristics predispose the thumb CMC to joint degeneration, especially related to volar or central wear. The patterns of degeneration, however, are not consistently identified, suggesting influences beyond inherent anatomy, repetitive load, and abnormal motion.</p>
</sec>
<sec><title>Conclusions</title>
<p>Additional studies to define patterns of normal use and wear will provide data to better characterize CMC OA and opportunities for tailored treatment, including prevention, delay of progression, and joint arthroplasty.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1007/s11999-014-3901-6) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Orthop Relat Res</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin. Orthop. Relat. Res</journal-id>
<journal-title-group><journal-title>Clinical Orthopaedics and Related Research</journal-title>
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<issn pub-type="ppub">0009-921X</issn>
<issn pub-type="epub">1528-1132</issn>
<publisher><publisher-name>Springer US</publisher-name>
<publisher-loc>Boston</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">25171934</article-id>
<article-id pub-id-type="pmc">4397810</article-id>
<article-id pub-id-type="publisher-id">3901</article-id>
<article-id pub-id-type="doi">10.1007/s11999-014-3901-6</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Society Awards</subject>
</subj-group>
</article-categories>
<title-group><article-title>The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Ladd</surname>
<given-names>Amy L.</given-names>
</name>
<degrees>MD</degrees>
<address><email>alad@stanford.edu</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Crisco</surname>
<given-names>Joseph J.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hagert</surname>
<given-names>Elisabet</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rose</surname>
<given-names>Jessica</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weiss</surname>
<given-names>Arnold-Peter C.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Orthopaedic Surgery, Stanford University, Chase Hand Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304 USA</aff>
<aff id="Aff2"><label></label>
Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI USA</aff>
<aff id="Aff3"><label></label>
Hand & Foot Surgery Center, Karolinska Institutet, Stockholm, Sweden</aff>
<aff id="Aff4"><label></label>
Department of Orthopaedic Surgery, Motion & Gait Analysis Laboratory, Lucile Packard Children’s Hospital, Palo Alto, CA USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>30</day>
<month>8</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>12</month>
<year>2014</year>
</pub-date>
<volume>472</volume>
<issue>12</issue>
<fpage>3605</fpage>
<lpage>3622</lpage>
<history><date date-type="received"><day>30</day>
<month>9</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>14</day>
<month>8</month>
<year>2014</year>
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</history>
<permissions><copyright-statement>© The Association of Bone and Joint Surgeons® 2014</copyright-statement>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>The paradoxical demands of stability and mobility reflect the purpose and function of the human thumb. Its functional importance is underscored when a thumb is congenitally absent, injured, or afflicted with degenerative arthritis. Prevailing literature and teaching implicate the unique shape of the thumb carpometacarpal (CMC) joint, as well as its ligament support, applied forces, and repetitive motion, as culprits causing osteoarthritis (OA). Sex, ethnicity, and occupation may predispose individuals to OA.</p>
</sec>
<sec><title>Questions/purposes</title>
<p>What evidence links ligament structure, forces, and motion to progressive CMC disease? Specifically: (1) Do unique attributes of the bony and ligamentous anatomy contribute to OA? (2) Can discrete joint load patterns be established that contribute to OA? And (3) can thumb motion that characterizes OA be measured at the fine and gross level?</p>
</sec>
<sec><title>Methods</title>
<p>We addressed the morphology, load, and movement of the human thumb, emphasizing the CMC joint in normal and arthritic states. We present comparative anatomy, gross dissections, microscopic analysis, multimodal imaging, and live-subject kinematic studies to support or challenge the current understanding of the thumb CMC joint and its predisposition to disease.</p>
</sec>
<sec><title>Results</title>
<p>The current evidence suggests structural differences and loading characteristics predispose the thumb CMC to joint degeneration, especially related to volar or central wear. The patterns of degeneration, however, are not consistently identified, suggesting influences beyond inherent anatomy, repetitive load, and abnormal motion.</p>
</sec>
<sec><title>Conclusions</title>
<p>Additional studies to define patterns of normal use and wear will provide data to better characterize CMC OA and opportunities for tailored treatment, including prevention, delay of progression, and joint arthroplasty.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1007/s11999-014-3901-6) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Association of Bone and Joint Surgeons® 2014</meta-value>
</custom-meta>
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</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Suède</li>
<li>États-Unis</li>
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<name sortKey="Crisco, Joseph J" sort="Crisco, Joseph J" uniqKey="Crisco J" first="Joseph J." last="Crisco">Joseph J. Crisco</name>
<name sortKey="Rose, Jessica" sort="Rose, Jessica" uniqKey="Rose J" first="Jessica" last="Rose">Jessica Rose</name>
<name sortKey="Weiss, Arnold Peter C" sort="Weiss, Arnold Peter C" uniqKey="Weiss A" first="Arnold-Peter C." last="Weiss">Arnold-Peter C. Weiss</name>
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<country name="Suède"><region name="Svealand"><name sortKey="Hagert, Elisabet" sort="Hagert, Elisabet" uniqKey="Hagert E" first="Elisabet" last="Hagert">Elisabet Hagert</name>
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