Academic Journal
Enhancing Preoperative Decision-Making in Trapeziometacarpal Joint Replacement: CT Hounsfield Units as a Reliable Predictor of Bone Quality.
| Τίτλος: | Enhancing Preoperative Decision-Making in Trapeziometacarpal Joint Replacement: CT Hounsfield Units as a Reliable Predictor of Bone Quality. |
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| Συγγραφείς: | Seth I; Peninsula Health, Frankston, VIC, Australia.; Monash University, Melbourne, VIC, Australia., Lim B; Peninsula Health, Frankston, VIC, Australia., Marcaccini G; Peninsula Health, Frankston, VIC, Australia.; University of Siena, Italy., Novo J; The University of Notre Dame, Sydney, NSW, Australia., Tso R; Peninsula Health, Frankston, VIC, Australia., Bruechert G; The University of Melbourne, VIC, Australia., Fogg Q; The University of Melbourne, VIC, Australia., Rozen WM; Peninsula Health, Frankston, VIC, Australia.; Monash University, Melbourne, VIC, Australia. |
| Πηγή: | Hand (New York, N.Y.) [Hand (N Y)] 2026 Oct; Vol. 21 (9), pp. 1458-1465. Date of Electronic Publication: 2025 Dec 10. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: SAGE Publications Country of Publication: United States NLM ID: 101264149 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-9455 (Electronic) Linking ISSN: 15589447 NLM ISO Abbreviation: Hand (N Y) Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2016- : Thousand Oaks, CA : SAGE Publications Original Publication: New York, N.Y. : Springer, c2006- |
| Ιατρικοί όροι (MeSH): | Trapezium Bone*/diagnostic imaging , Trapezium Bone*/surgery , Tomography, X-Ray Computed*/methods , Carpometacarpal Joints*/surgery , Carpometacarpal Joints*/diagnostic imaging , Bone Density* , Arthroplasty, Replacement*, Metacarpal Bones/diagnostic imaging ; Metacarpal Bones/surgery ; Humans ; Female ; Male ; Middle Aged ; Aged ; Preoperative Care |
| Περίληψη: | Background: Successful trapeziometacarpal (TM) joint arthroplasty depends heavily on bone quality, particularly of the trapezium, where cup loosening remains a leading cause of implant failure. While dual-energy x-ray absorptiometry measures bone mineral density (BMD), it lacks regional specificity. Computed tomography (CT)-derived Hounsfield units (HU) offer quantitative, site-specific bone density estimation and may serve as a surrogate for BMD in preoperative planning. This study investigated the relationship between CT-derived HU values and tactilely perceived bone hardness of the trapezium to evaluate HU as a reliable predictor of bone quality. Methods: Ten embalmed Body Donor hands were scanned using a Philips Spectral CT 7500 scanner. Bone segmentation and density analyses were conducted in 3D Slicer software, focusing on trabecular regions of the trapezium (proximal, ridge, and submetacarpal) and the first metacarpal (proximal, medial, and distal). Hounsfield unit values were converted to density (g/cm3) using validated equations. An experienced anatomist assessed trapezium hardness ("soft" or "hard") using bone forceps. Correlations between HU values, bone volume, and perceived hardness were analyzed using Pearson correlation coefficient. Results: The mean trapezium HU was 354 (682.88 g/cm3), with regional trabecular variation: proximal 160.7 HU, ridge 286.5 HU, submetacarpal 241.7 HU. The first metacarpal demonstrated broader density variation (-285.8 to 228.8 HU). Hounsfield unit values correlated significantly with perceived hardness (r = .71, P = .02), whereas bone volume showed no correlation (r = .08, P = .82). Male trapezia displayed higher HU and density (472.7 ± 89.8 HU; 740.9 ± 44.0 g/cm3) than females (436.1 ± 87.2 HU; 723.0 ± 42.7 g/cm3). Conclusions: Computed tomography-derived HU values strongly correlate with perceived bone hardness and provide an objective surrogate for assessing bone quality in TM joint arthroplasty. Incorporating preoperative HU assessment may guide implant selection and fixation strategies, reducing trapezium cup loosening and implant failure. |
| Competing Interests: | Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Contributed Indexing: | Keywords: CT imaging; bone density; joint replacement; osteoarthritis; trapezium |
| Entry Date(s): | Date Created: 20251210 Date Completed: 20260912 Latest Revision: 20260912 |
| Update Code: | 20260912 |
| PubMed Central ID: | PMC12695592 |
| DOI: | 10.1177/15589447251391377 |
| PMID: | 41368716 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1558-9455 |
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| DOI: | 10.1177/15589447251391377 |