Trapezı̇ometakarpal Osteoartrı̇t Hastalarında Adduktör Pollı̇sı̇s Kas Elastı̇kı̇yetı̇nı̇n İncelenmesı

Abstract

Karademir, F. Investigation of Adductor Pollicis Muscle Elasticity in Patients with Trapeziometacarpal Osteoarthritis. Hacettepe University, Graduate School of Health Sciences, Orthopedic Physiotherapy and Rehabilitation Program, Doctoral Thesis, Ankara, 2024. The aim of this study was to compare the thickness and elasticity of the adductor pollicis (AdP) and first dorsal interosseous (FDI) muscles in patients with trapeziometacarpal osteoarthritis (TMC OA) and asymptomatic individuals, to investigate the relationship between muscle elasticity and demographic and clinical findings, and to assess whether muscle elasticity could be used as a diagnostic tool for TMC OA. The study included 18 TMC OA patients (29 hands) and 13 asymptomatic individuals (26 hands). The patients' symptom duration and pain intensity were assessed. In both groups, thumb range of motion, grip and pinch strength were measured. Muscle thickness measurements were performed using B-mode ultrasonography, while muscle elasticity measurements were conducted using shear wave elastography (SWE). Hand functional status was assessed using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, the Michigan Hand Outcomes Questionnaire, and the Duruöz Hand Index, while quality of life was assessed using the Short Form-36 (SF-36) questionnaire. A statistically significant difference in AdP muscle elasticity was found between the groups (p=0.021);. The OA group had significantly higher AdP muscle elasticity value. There was no significant difference in the FDI muscle elasticity (p=0.128), AdP and FDI muscle thickness between groups. In the OA group, palmar abduction angle, opposition score, and standard, tripod, and tip strengths were significantly lower (p>0.05). In the TMC OA group, a significant positive correlation was found between AdP muscle elasticity and age (r=0.469, p=0.01), and a significant positive correlation was found between BDI muscle elasticity and duration and pinch strength (r=0,467 p=0,023; r=0,437 p=0,014). The optimal cut-off point of AdP muscle elasticity for the diagnosis of TMC OA was determined as 8.9 kPa and the sensitivity, specificity and accuracy of this value were calculated as 86%, 46% and 67%, respectively. The results of the study showed that the AdP muscle elasticity increased in patients with TMC OA and that this increase was positively correlated with age. This finding supports the need for of interventions to maintain the viscoelastic properties of the AdP muscle, which plays an effective role in the dynamic stabilisation of the TMC joint. In addition, quantification of AdP elasticity using SWE may be a useful method for diagnosing TMC OA.