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Shape predicts osteoarthritis progression in the first carpometacarpal joint
Wan M R Rusli1,2, Ana Bandarrinha Brandão1,3, Joseph J Crisco4
1Department of Bioengineering, Imperial College London, London, United Kingdom.
Introduction:
Statistical shape modelling enables global geometric features of bones to be quantified and previously has demonstrated differences between healthy and osteoarthritic populations, including at the first carpometacarpal (CMC) joint. However, no study has examined how the variability in the shapes of the metacarpal and trapezium change with time. The aim of this study was to determine if baseline morphological differences in the first metacarpal and trapezium distinguish individuals with progressive first CMC joint osteoarthritis (OA) from non-progressors. It was hypothesized that distinct morphological differences exist in these bones between participants with first CMC joint OA who experience disease progression and those who do not.
Methods:
Longitudinal three-dimensional (3D) meshes from 85 osteoarthritic first carpometacarpal (CMC) joints (46 females and 39 males; 57.3 ± 8.4 years) were categorized as non-progressors (n = 49) or progressors (n = 36). Statistical shape modelling quantified morphological changes between baseline and follow-up (1.5 or 6 years) scans for the first metacarpal and trapezium. A non-parametric combination test was used to identify significant morphological differences between time-points.
Results:
Morphological differences were identified in both the first metacarpal and trapezium between participants with OA of the first CMC joint that progressed and those that did not. On the first metacarpal, the articulation surface tilt angle and protrusion at the volar beak were two morphological parameters that differed between the progressor and non-progressor groups. On the trapezium, depressions at the volar and radial regions of the articulating surface, and protrusions at the radial and ulnar borders of the carpometacarpal facet were indicated by the shape models for the progressor group.
Discussion:
These findings may be used to stratify treatment approaches for CMC joint OA, avoiding unnecessary interventions for those who are unlikely to experience disease progression, while monitoring those who are more likely to experience progression more closely.
