Trapeziometacarpal subluxation predisposes to incident trapeziometacarpal osteoarthritis (OA): the Framingham Study
Trapeziometacarpal subluxation predisposes to incident trapeziometacarpal osteoarthritis (OA): the Framingham Study
复制标题
DOI：
10.1016/j.joca.2005.06.007
复制
发表时间：
2005-11-01
影响因子：
7
通讯作者：
Felson, DT
中科院分区：
文献类型：
--
作者：
Hunter, DJ;Zhang, Y;Felson, DT
目的：拇指掌关节骨关节炎（CA）是一种常见的疾病，可导致严重的疼痛、不稳定、畸形和运动丧失。据推测，斜跖关节不稳定加上剧烈使用可能会导致骨关节炎。然而，到目前为止，还没有纵向评估来确定这一假设是否正确。我们研究了桡侧半脱位与胸片上胸骨关节炎风险的关系。方法：采用巢式病例对照研究。我们将病例的评估限制在基线时没有胸片胸骨关节炎的受试者（1967年）。在后来的检查中，我们将偶发的掌骨斜方骨关节炎定义为该关节发生改良的Kellgren和Lawrence 2级病变（1992-1993）。用数字计算卡尺测量第一掌骨基部桡性半脱位，以及第一掌骨基部覆盖斜方关节面的面积。我们使用条件逻辑回归模型检验了性别特定的桡骨半脱位四分位数组与掌侧斜骨CA风险的关系。结果：我们评估了203名男性和431名女性。在调整了年龄、惯用手性、患CA的其他关节数量和握力后，从桡骨半脱位的最低四分位数到最高四分位数，男性患斜跖骨CA风险的比值比分别为1.0、1.8、2.7和3.1（趋势P = 0.015）。女性桡骨半脱位四分位数与发生的掌方骨关节炎之间没有显著的关系。结论：本研究提供了证据，表明桡骨半脱位易导致男性骨关节炎。(c) 2005年国际骨关节炎研究学会。Elsevier Ltd.出版。版权所有。
Objective: Osteoarthritis (CA) of the thumb carpo-metacarpal joint is a common condition that can lead to substantial pain, instability, deformity, and loss of motion. It has been hypothesized that instability of the trapeziometacarpal joint combined with strenuous use can potentially lead to OA. However, as yet there have been no longitudinal evaluations to determine if this hypothesis is true. We examined the relation of radial subluxation to the risk of radiographic OA at trapeziometacarpal joint.Methods: We conducted a nested case-control study. We restricted our evaluation of cases to subjects with no radiographic trapeziometacarpal OA at baseline (1967). We defined incident trapeziometacarpal OA as the development of a modified Kellgren and Lawrence grade 2 in that joint at a later examination (1992-1993). Radial subluxation of the base of the first metacarpal off the trapezium and the amount of the base of the first metacarpal covering the articulating surface of the trapezium were measured using a digital calculation caliper. We examined the relation of gender-specific quartile groups of radial subluxation to the risk of trapeziometacarpal CA using a conditional logistic regression model.Results: We assessed 203 men and 431 women. After adjusting for age, handedness, number of other joints with CA, and grip strength, the odds ratios for the risk of trapeziometacarpal CA in men were 1.0, 1.8, 2.7, and 3.1 from the lowest quartile of radial subluxation to the highest quartile, respectively (P for trend = 0.015). There was no significant relationship between radial subluxation quartiles and incident trapeziometacarpal OA in women.Conclusion: This study provides evidence that radial subluxation predisposes to subsequent OA of the trapeziometacarpal joint in men. (c) 2005 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.