Ultrastructure and Innervation of Thumb Carpometacarpal Ligaments in Surgical Patients With Osteoarthritis

详细信息    查看全文

• 作者：Nathalie Mobargha MD (1)
  Cassie Ludwig BS (2)
  Amy L. Ladd MD (3)
  Elisabet Hagert MD ; PhD (1) (4)
  
• 刊名：Clinical Orthopaedics and Related Research?
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：472
• 期：4
• 页码：1146-1154
• 全文大小：1,286 KB
• 参考文献：1. Bettinger PC, Linscheid RL, Berger RA, Cooney WP 3rd, An KN. An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. / J Hand Surg Am. 1999;24:786-98. CrossRef
  2. Bettinger PC, Smutz WP, Linscheid RL, Cooney WP 3rd, An KN. Material properties of the trapezial and trapeziometacarpal ligaments. / J Hand Surg Am. 2000;25:1085-095. CrossRef
  3. Bosmans B, Verhofstad MH, Gosens T. Traumatic thumb carpometacarpal joint dislocations. / J Hand Surg Am. 2008;33:438-41. CrossRef
  4. Brandt KD, Dieppe P, Radin E. Etiopathogenesis of osteoarthritis. / Med Clin North Am. 2009;93:1-4, xv.
  5. Colman M, Mass DP, Draganich LF. Effects of the deep anterior oblique and dorsoradial ligaments on trapeziometacarpal joint stability. / J Hand Surg Am. 2007;32:310-17. CrossRef
  6. Cooney WP 3rd, Lucca MJ, Chao EY, Linscheid RL. The kinesiology of the thumb trapeziometacarpal joint. / J Bone Joint Surg Am. 1981;63:1371-381.
  7. Diederichsen LP, Norregaard J, Krogsgaard M, Fischer-Rasmussen T, Dyhre-Poulsen P. Reflexes in the shoulder muscles elicited from the human coracoacromial ligament. / J Orthop Res. 2004;22:976-83. CrossRef
  8. Doerschuk SH, Hicks DG, Chinchilli VM, Pellegrini VD Jr. Histopathology of the palmar beak ligament in trapeziometacarpal osteoarthritis. / J Hand Surg Am. 1999;24:496-04. CrossRef
  9. Eaton RG, Glickel SZ. Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. / Hand Clin. 1987;3:455-71.
  10. Fick A. [ / The Joint With Saddle Shaped Surface] [in German]. Heidelberg, Germany: Adademische Verlagshandlung; 1854:314-21.
  11. Freeman MA, Wyke B. Articular reflexes at the ankle joint: an electromyographic study of normal and abnormal influences of ankle-joint mechanoreceptors upon reflex activity in the leg muscles. / Br J Surg. 1967;54:990-001. CrossRef
  12. Hagert E. / Wrist Ligaments—Innervation Patterns and Ligamento-muscular Reflexes. PhD thesis, Department of Clinical Science and Education, Section of Hand Surgery. Stockholm, Sweden: Karolinska Institutet; 2008:1-1.
  13. Hagert E. Proprioception of the wrist following posterior interosseous sensory neurectomy. / J Hand Surg Am. 2010;35:690-91; author reply 691.
  14. Hagert E, Forsgren S, Ljung BO. Differences in the presence of mechanoreceptors and nerve structures between wrist ligaments may imply differential roles in wrist stabilization. / J Orthop Res. 2005;23:757-63. CrossRef
  15. Hagert E, Garcia-Elias M, Forsgren S, Ljung BO. Immunohistochemical analysis of wrist ligament innervation in relation to their structural composition. / J Hand Surg Am. 2007;32:30-6. CrossRef
  16. Hagert E, Lee J, Ladd AL. Innervation patterns of thumb trapeziometacarpal joint ligaments. / J Hand Surg Am. 2012;37:706-14.e701.
  17. Hagert E, Ljung BO, Forsgren S. General innervation pattern and sensory corpuscles in the scapholunate interosseous ligament. / Cells Tissues Organs. 2004;177:47-4. CrossRef
  18. Hagert E, Persson JK, Werner M, Ljung BO. Evidence of wrist proprioceptive reflexes elicited after stimulation of the scapholunate interosseous ligament. / J Hand Surg Am. 2009;34:642-51. CrossRef
  19. Hunter DJ, Zhang Y, Sokolove J, Niu J, Aliabadi P, Felson DT. Trapeziometacarpal subluxation predisposes to incident trapeziometacarpal osteoarthritis (OA): the Framingham Study. / Osteoarthritis Cartilage. 2005;13:953-57. CrossRef
  20. Hurley MV. The role of muscle weakness in the pathogenesis of osteoarthritis. / Rheum Dis Clin North Am. 1999;25:283-98, vi.
  21. Imaeda T, An KN, Cooney WP 3rd, Linscheid R. Anatomy of trapeziometacarpal ligaments. / J Hand Surg Am. 1993;18:226-31. CrossRef
  22. Konttinen YT, Tiainen VM, Gomez-Barrena E, Hukkanen M, Salo J. Innervation of the joint and role of neuropeptides. / Ann N Y Acad Sci. 2006;1069:149-54. CrossRef
  23. Kwan MM, Close JC, Wong AK, Lord SR. Falls incidence, risk factors, and consequences in Chinese older people: a systematic review. / J Am Geriatr Soc. 2011;59:536-43. CrossRef
  24. Ladd AL, Lee J, Hagert E. Macroscopic and microscopic analysis of the thumb carpometacarpal ligaments: a cadaveric study of ligament anatomy and histology. / J Bone Joint Surg Am. 2012;94:1468-477. CrossRef
  25. Lee HM, Cheng CK, Liau JJ. Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency. / Knee. 2009;16:387-91. CrossRef
  26. Lee J, Ladd A, Hagert E. Immunofluorescent triple-staining technique to identify sensory nerve endings in human thumb ligaments. / Cells Tissues Organs. 2012;195:456-64. CrossRef
  27. Lephart SM, Fu FH / Proprioception and Neuromuscular Control in Joint Stability; Introduction to the Sensorimotor System. Champaign, IL, USA: Human Kinetics; 2000.
  28. McGonagle D, Tan AL, Carey J, Benjamin M. The anatomical basis for a novel classification of osteoarthritis and allied disorders. / J Anat. 2010;216:279-91. CrossRef
  29. Napier JR. The form and function of the carpo-metacarpal joint of the thumb. / J Anat. 1955;89:362-69.
  30. Palmer I. Pathophysiology of the medical ligament of the knee joint. / Acta Chir Scand. 1958;115:312-18.
  31. Pellegrini VD Jr. Osteoarthritis of the trapeziometacarpal joint: the pathophysiology of articular cartilage degeneration. I. Anatomy and pathology of the aging joint. / J Hand Surg Am. 1991;16:967-74. CrossRef
  32. Pellegrini VD Jr. The ABJS 2005 Nicolas Andry Award: osteoarthritis and injury at the base of the human thumb: survival of the fittest? / Clin Orthop Relat Res. 2005;438:266-76. CrossRef
  33. Phillips D, Petrie S, Solomonow M, Zhou BH, Guanche C, D’Ambrosia R. Ligamentomuscular protective reflex in the elbow. / J Hand Surg Am. 1997;22:473-78. CrossRef
  34. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. / J Athl Train. 2002;37:71-9.
  35. Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. / J Athl Train. 2002;37:80-4.
  36. Salo P. The role of joint innervation in the pathogenesis of arthritis. / Can J Surg. 1999;42:91-00.
  37. Salo PT, Hogervorst T, Seerattan RA, Rucker D, Bray RC. Selective joint denervation promotes knee osteoarthritis in the aging rat. / J Orthop Res. 2002;20:1256-264. CrossRef
  38. Salo PT, Seeratten RA, Erwin WM, Bray RC. Evidence for a neuropathic contribution to the development of spontaneous knee osteoarthrosis in a mouse model. / Acta Orthop Scand. 2002;73:77-4. CrossRef
  39. Sharma L. Proprioceptive impairment in knee osteoarthritis. / Rheum Dis Clin North Am. 1999;25:299-14, vi.
  40. Skinner HB, Barrack RL, Cook SD. Age-related decline in proprioception. / Clin Orthop Relat Res. 1984;184:208-11.
  41. Slaoui M, Fiette L. Histopathology procedures: from tissue sampling to histopathological evaluation. / Methods Mol Biol. 2011;691:69-2. CrossRef
  42. Strauch RJ, Behrman MJ, Rosenwasser MP. Acute dislocation of the carpometacarpal joint of the thumb: an anatomic and cadaver study. / J Hand Surg Am. 1994;19:93-8. CrossRef
  43. Tan AL, Toumi H, Benjamin M, Grainger AJ, Tanner SF, Emery P, McGonagle D. Combined high-resolution magnetic resonance imaging and histological examination to explore the role of ligaments and tendons in the phenotypic expression of early hand osteoarthritis. / Ann Rheum Dis. 2006;65:1267-272. CrossRef
  44. Tomita K, Berger EJ, Berger RA, Kraisarin J, An KN. Distribution of nerve endings in the human dorsal radiocarpal ligament. / J Hand Surg Am. 2007;32:466-73. CrossRef
  45. Van Brenk B, Richards RR, Mackay MB, Boynton EL. A biomechanical assessment of ligaments preventing dorsoradial subluxation of the trapeziometacarpal joint. / J Hand Surg Am. 1998;23:607-11. CrossRef
  46. Weerakkody NS, Blouin JS, Taylor JL, Gandevia SC. Local subcutaneous and muscle pain impairs detection of passive movements at the human thumb. / J Physiol. 2008;586:3183-193. CrossRef
  
• 作者单位：Nathalie Mobargha MD (1)
  Cassie Ludwig BS (2)
  Amy L. Ladd MD (3)
  Elisabet Hagert MD, PhD (1) (4)
  
  1. Department of Clinical Science and Education, Karolinska Institute, Sjukhusbacken 10, 118 83, Stockholm, Sweden
  2. Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
  3. Department of Orthopaedic Surgery, Robert A. Chase Hand & Upper Limb Center, Stanford University, Stanford, CA, USA
  4. Hand & Foot Surgery Center, Stockholm, Sweden
  
• ISSN：1528-1132

文摘

Background The complex configuration of the thumb carpometacarpal (CMC-1) joint relies on musculotendinous and ligamentous support for precise circumduction. Ligament innervation contributes to joint stability and proprioception. Evidence suggests abnormal ligament innervation is associated with osteoarthritis (OA) in large joints; however, little is known about CMC-1 ligament innervation characteristics in patients with OA. We studied the dorsal radial ligament (DRL) and the anterior oblique ligament (AOL), ligaments with a reported divergent presence of mechanoreceptors in nonosteoarthritic joints. Questions/purposes This study’s purposes were (1) to examine the ultrastructural architecture of CMC-1 ligaments in surgical patients with OA; (2) to describe innervation, specifically looking at mechanoreceptors, of these ligaments using immunohistochemical techniques and compare the AOL and DRL in terms of innervation; and (3) to determine whether there is a correlation between age and mechanoreceptor density. Methods The AOL and DRL were harvested from 11 patients with OA during trapeziectomy (10 women, one man; mean age, 67 years). The 22 ligaments were sectioned in paraffin and analyzed using immunoflourescent triple staining microscopy. Results In contrast to the organized collagen bundles of the DRL, the AOL appeared to be composed of disorganized connective tissue with few collagen fibers and little innervation. Mechanoreceptors were identified in CMC-1 ligaments of all patients with OA. The DRL was significantly more innervated than the AOL. There was no significant correlation between innervation of the DRL and AOL and patient age. Conclusions The dense collagen structure and rich innervation of the DRL in patients with OA suggest that the DRL has an important proprioceptive and stabilizing role. Clinical Relevance Ligament innervation may correlate with proprioceptive and neuromuscular changes in OA pathophysiology and consequently support further investigation of innervation in disease prevention and treatment strategies.