Full Length Article| Volume 35, ISSUE 3, P367-376, July 2022

The biomechanics of osteoarthritis in the hand: Implications and prospects for hand therapy

Published:December 10, 2022DOI:



      The unique anatomy of the human hand makes it possible to carefully manipulate tools, powerfully grasp objects, and even throw items with precision. These apparent contradictory functions of the hand, high mobility for manual dexterity vs high stability during forceful grasping, imply that daily activities impose a high strain on a relatively instable joint. This makes the hand susceptible to joint disorders such as osteoarthritis. Both systemic (eg, genetics, hormones) and mechanical factors (eg, joint loading) are important in the development of osteoarthritis, but the precise pathomechanism remains largely unknown. This paper focuses on the biomechanical factors in the disease process and how hand therapists can use this knowledge to improve treatment and research.


      Multiple factors are involved in the onset and development of osteoarthritis in the hand. Comprehension of the biomechanics helps clinicians establish best practices for orthotics intervention, exercise, and joint protection programs even in de absence of clear evidence-based guidelines. The effect and reach of hand therapy for OA patients can be expanded substantially when intervention parameters are optimized and barriers to early referrals, access reimbursement, and adherence are addressed. Close and early collaboration between hand therapists and primary care, women's health, rheumatology, and hand surgery providers upon diagnosis, and with hand surgeons pre and postoperatively, combined with advances in the supporting science and strategies to enhance adherence, appear to be a promising way forward.


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      JHT Read for Credit

      Quiz: # 923

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1
        The study design is
        • a
        • b
          case series
        • c
          retrospective cohort
        • d
          prospective cohort
      • # 2
        The reoperation rate was approximately
        • a
        • b
        • c
        • d
      • # 3
        The authors investigated
        • a
        • b
          reoperation rates
        • c
          therapy utilization
        • d
          all of the above
      • # 4
        The most common reoperation procedure was
        • a
          delayed secondary repair
        • b
        • c
        • d
          Hunter rod and tendon graft
      • # 5
        Higher rates of reoperation were associated with higher number of therapy sessions
        • a
        • b
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.