J Wrist Surg 2020; 09(01): 019-021
DOI: 10.1055/s-0039-1693043
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Volume of the Thumb Carpometacarpal Joint

Kevin F. Lutsky
1   Division of Hand & Upper Extremity Surgery, The Rothman Institute, Philadelphia, Pennsylvania
,
Fred Liss
1   Division of Hand & Upper Extremity Surgery, The Rothman Institute, Philadelphia, Pennsylvania
,
Jack Graham
2   Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Pedro K. Beredjiklian
1   Division of Hand & Upper Extremity Surgery, The Rothman Institute, Philadelphia, Pennsylvania
› Author Affiliations
Funding None.
Further Information

Publication History

05 December 2018

24 May 2019

Publication Date:
09 July 2019 (online)

Abstract

Background The volume of the carpometacarpal joint of the thumb (TCMC) and its capacity to accommodate fluid injection is unknown.

Questions/Purpose The purpose of the present study is to assess the volume of the TCMC.

Methods Forty-two thumbs undergoing surgical treatment for symptomatic TCMCJ osteoarthritis (OA) were evaluated. Prior to the start of the surgical procedure saline was injected into the TCMC until resistance was felt and no further saline could be injected. The maximum volume (MaxVol) of injectate was measured and recorded.

Results Mean MaxVol among all patients was 0.9 cc (range: 0.2–3.0 cc). There were 15 patients with 1 cc or more injected, the rest were less than 1 cc. The mean MaxVol for Eaton 2 thumbs was 1.5 cc, for Eaton 3 thumbs 0.9 cc, and for Eaton 4 thumbs 0.7 cc, with negative correlation between Eaton stage and MaxVol.

Conclusion TCMC has limited capacity for injected fluid.

Level of Evidence This is a Level II, diagnostic study.

Ethical Committee Review

This study was reviewed and approved by an Institutional Review Board. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was waived per institutional protocol. Informed consent was waived per institutional protocol.


 
  • References

  • 1 Van Heest AE, Kallemeier P. Thumb carpal metacarpal arthritis. J Am Acad Orthop Surg 2008; 16 (03) 140-151
  • 2 Hoffler II CE, Matzon JL, Lutsky KF, Kim N, Beredjiklian PK. Radiographic Stage Does Not Correlate With Symptom Severity in Thumb Basilar Joint Osteoarthritis. J Am Acad Orthop Surg 2015; 23 (12) 778-782
  • 3 Spaans AJ, van Minnen LP, Kon M, Schuurman AH, Schreuders AR, Vermeulen GM. Conservative treatment of thumb base osteoarthritis: a systematic review. J Hand Surg Am 2015; 40 (01) 16-21.e1 , 6
  • 4 Day CS, Gelberman R, Patel AA, Vogt MT, Ditsios K, Boyer MI. Basal joint osteoarthritis of the thumb: a prospective trial of steroid injection and splinting. J Hand Surg Am 2004; 29 (02) 247-251
  • 5 Heyworth BE, Lee JH, Kim PD, Lipton CB, Strauch RJ, Rosenwasser MP. Hylan versus corticosteroid versus placebo for treatment of basal joint arthritis: a prospective, randomized, double-blinded clinical trial. J Hand Surg Am 2008; 33 (01) 40-48
  • 6 McCann PA, Wakeley CJ, Amirfeyz R. The effect of ultrasound guided steroid injection on progression to surgery in thumb CMC arthritis. Hand Surg 2014; 19 (01) 49-52
  • 7 Monfort J, Rotés-Sala D, Segalés N. , et al. Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study. Joint Bone Spine 2015; 82 (02) 116-121
  • 8 Swindells MG, Logan AJ, Armstrong DJ, Chan P, Burke FD, Lindau TR. The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis. Ann R Coll Surg Engl 2010; 92 (08) 680-684
  • 9 Weiss AC, Goodman AD. Thumb Basal Joint Arthritis. J Am Acad Orthop Surg 2018; 26 (16) 562-571
  • 10 Matziolis G, Roehner E, Windisch C, Wagner A. The volume of the human knee joint. Arch Orthop Trauma Surg 2015; 135 (10) 1401-1403
  • 11 Taras JS, Raphael JS, Pan WT, Movagharnia F, Sotereanos DG. Corticosteroid injections for trigger digits: is intrasheath injection necessary?. J Hand Surg Am 1998; 23 (04) 717-722