Innervation Patterns of Thumb Trapeziometacarpal Joint Ligaments

Hagert, Elisabet; Lee, Jung Hwa; Ladd, Amy L.

doi:10.1016/j.jhsa.2011.12.038

Cited by 67 publications

(63 citation statements)

References 49 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results confirm that there is a considerable structural difference between DRL and AOL in surgical patients with OA, as shown in previous cadaveric macro-and microscopic studies [16,24,26]. Where DRL is highly organized with dense collagenous bundles and an abundance of nuclei, AOL is mainly composed of loose connective tissue with sparse nuclei.…”

Section: Discussionsupporting

confidence: 91%

“…The Pacinian corpuscle, a rapidly adapting receptor activated by changes in joint velocity and joint compression, was an uncommon finding in both ligaments. Subsequently, our current clinical findings concur with previous cadaveric studies, which have reported greater innervation of the dorsal deltoid ligaments, compared with the innervation of AOL and ulnar collateral ligaments [16]. The abundance of nerve endings and mechanoreceptors in the DRL may partially explain why patients with CMC-1 OA often experience dorsal joint pain.…”

Section: Discussionsupporting

confidence: 90%

“…Where DRL is highly organized with dense collagenous bundles and an abundance of nuclei, AOL is mainly composed of loose connective tissue with sparse nuclei. Corresponding findings have been demonstrated in the dorsal wrist and scapholunate interosseous ligaments [14][15][16][17]44], where these ligaments had ample innervation compared with volar ligaments. Our histologic observations also add support to the theory that the DRL is a primary stabilizer of CMC-1 [2,3,5,42,45].…”

Section: Discussionsupporting

confidence: 58%

“…A potential advantage of our study was the use of fresh paraffin-embedded tissue that had not previously been frozen as opposed to fresh-frozen cadavers. Our surgical sampling allowed for more precise analysis because there are less artifacts and better quality of nerve endings when compared with freshfrozen specimens [16].…”

Section: Discussionmentioning

confidence: 99%

“…This has been shown in normal cadaveric dissections [16,24,26] but the characteristics in surgical patients are unknown. (2) Are sensory nerve endings, ie, mechanoreceptors, present in the AOL and DRL of patients with CMC-1 OA, and, if so, is there a difference in mechanoreceptor types between the AOL and DRL, respectively?…”

Section: Introductionmentioning

confidence: 90%

See 4 more Smart Citations

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

Mobargha

Ludwig

Ladd

et al. 2014

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%