Orthopaedic Surgery Department, Kaplan Medical Center, 1st Pasternak Road, Rehovot, 7661041, Israel.
Orthopaedic Surgery Department, Kaplan Medical Center, 1st Pasternak Road, Rehovot, 7661041, Israel.
Hand Surg Rehabil. 2024 Oct;43(5):101777. doi: 10.1016/j.hansur.2024.101777. Epub 2024 Sep 14.
To explore the distribution and prevalence of osteoarthritis in metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints in long fingers in a cadaveric study, and to discuss potential biomechanical influences on these patterns.
This cadaveric study evaluated 144 metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints from 12 embalmed cadaver hands. A dorsal dissection approach was used to expose the joints, which were then marked with color-coded pegs for consistent orientation during imaging. High-resolution digital images of the distal articular surfaces were captured for analysis. The images were analyzed using custom software to quantify osteoarthritic areas, distinguishing between radial and ulnar aspects. Percentage affected joint surface was calculated using pixel-based measurements. Statistical analysis was used the Student t-test and ANOVA, with the significance threshold set at p < 0.05 and 95% confidence intervals RESULTS: The ulnar side of the proximal interphalangeal joint in digits 2 and 3 showed higher prevalence of osteoarthritis (59.31% ± 15.48%) than the radial side (40.68% ± 15.48%), p = 0.007; in contrast, for digits 4 and 5, prevalence was greater on the radial (54.3% ± 10.99%) than the ulnar side (45.7% ± 10.99%), p = 0.007. No significant differences were noted in osteoarthritis distribution between the radial and ulnar aspects of the metacarpophalangeal and distal interphalangeal joints.
This study identified distinct patterns of osteoarthritis distribution in long-finger joints, with greater prevalence in the proximal interphalangeal joints. Although there were differences between stable (digits 2 and 3) and mobile (digits 4 and 5) fingers, further research is necessary to conclusively determine the role of biomechanical forces in the development of osteoarthritis. These findings lay the groundwork for future studies of the pathophysiology of osteoarthritis in the hand, and could guide the development of preventive and therapeutic interventions.
通过尸体研究探索长指的掌指、近侧指间和远侧指间关节的骨关节炎在这些关节中的分布和流行情况，并讨论这些模式的潜在生物力学影响。
本尸体研究评估了 12 具防腐尸体手的 144 个掌指、近侧指间和远侧指间关节。采用背侧解剖入路暴露关节，并用彩色编码钉标记以在成像过程中保持一致的方向。对远端关节面进行高分辨率数字图像采集用于分析。使用定制软件分析图像以量化骨关节炎区域，区分桡侧和尺侧。使用基于像素的测量值计算受影响关节表面的百分比。使用学生 t 检验和 ANOVA 进行统计分析，显著性阈值设为 p < 0.05 和 95%置信区间。
第 2 指和第 3 指的近侧指间关节尺侧的骨关节炎患病率（59.31% ± 15.48%）高于桡侧（40.68% ± 15.48%），p = 0.007；相比之下，第 4 指和第 5 指的桡侧（54.3% ± 10.99%）的患病率高于尺侧（45.7% ± 10.99%），p = 0.007。掌指关节和远侧指间关节的桡侧和尺侧之间的骨关节炎分布无显著差异。
本研究确定了长指关节中骨关节炎分布的独特模式，近侧指间关节的患病率更高。尽管稳定（第 2 指和第 3 指）和活动（第 4 指和第 5 指）手指之间存在差异，但需要进一步研究才能确定生物力学力在骨关节炎发展中的作用。这些发现为手部骨关节炎的病理生理学的进一步研究奠定了基础，并为预防和治疗干预措施的发展提供了指导。
