Illuminating the trapeziometacarpal joint: Dawn for optical coherence tomography in osteoarthritis

Osteoarthritis (OA) is a debilitating degenerative joint disease affecting millions of patients worldwide and is characterized by loss of cartilage thickness and quality in affected joints. OA of the trapeziometacarpal (TMC) joint or thumb base joint especially gives rise to loss of hand function and disability. However, clinical imaging strategies have thus far been unable to accurately assess the thin cartilage layers lining small joints like the TMC joint. Moreover, a degree of discrepancy exists between clinical symptoms and OA features as seen on clinical imaging studies, hampering treatment choice. In an effort to eventually provide the clinician with additional and more accurate information on the status of articular cartilage in TMC OA, this thesis explores the use of Optical Coherence Tomography (OCT) in imaging of articular cartilage. OCT uses the back-reflection of near-infrared light to produce high resolution cross-sectional images. In this thesis, the use of OCT in both animal cartilage models and in-situ imaging of human cadaver TMC joints is described. The emphasis of the various studies conducted in this thesis lie on OCT signal analysis/quantification, cartilage thickness measurement comparison to reference standard imaging and co-registration/3D reconstruction of depicted joint structures