Xu L, Strauch R J, Ateshian G A, Pawluk R J, Mow V C, Rosenwasser M P
Department of Mechanical Engineering, Orthopaedic Research Laboratory, Columbia University, New York, NY 10032, USA.
J Hand Surg Am. 1998 May;23(3):454-64. doi: 10.1016/S0363-5023(05)80463-0.
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.
对46个骨关节炎性拇指腕掌关节的关节形态进行了定量分析,并分析了其在性别、年龄、部位和解剖学骨关节炎分期方面的差异。研究发现,对于骨关节炎性拇指腕掌关节,(1) 尽管考虑到随着年龄或疾病导致软骨层变薄,关节接触面积无显著差异,但老年和严重退变关节的相对关节面比中年及轻度或中度退变关节的相对关节面更匹配;(2) 骨关节炎导致的关节形态显著变化仅发生在严重退变的关节中;(3) 在涉及相似关节负荷的类似日常生活活动中,女性的关节比男性的关节匹配度更低,接触面积更小,且可能承受更高的接触应力;(4) 大多角骨背尺侧和掌骨背侧的骨关节炎变化较轻,这些部位已知是低负荷区域。