Relationship of Serum Relaxin to Generalized and Trapezial-Metacarpal Joint Laxity

Wolf, Jennifer Moriatis; Williams, Allison; Delaronde, Steven; Leger, Robin R.; Clifton, Kari B.; King, Karen B.

doi:10.1016/j.jhsa.2013.01.019

Cited by 27 publications

(27 citation statements)

References 32 publications

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“…Physiologic levels of circulating relaxin have been defined based on the pregnant female, but there is limited information on normal levels in postmenopausal women or older men, who made up the majority of our cohort. In a large study of volunteers [48], we noted detectable relaxin levels in 121 of 287 subjects (42%) with an average overall serum relaxin level of 1.8 pg/mL with average detectable relaxin levels of 2.4 pg/mL in women 60 years and older with 2.6 pg/mL in the same age group in men. It is interesting to note that serum relaxin was higher on average in our group with surgically treated arthritis than in a similar age group of volunteers.…”

Section: Discussionmentioning

confidence: 86%

Relationship of Relaxin Hormone and Thumb Carpometacarpal Joint Arthritis

Wolf

Scher

Etchill

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The female predominance in thumb carpometacarpal (CMC) joint arthritis has led to speculation that reproductive hormones or hypermobility are responsible. Evidence shows that patients with pathologic laxity have a higher rate of thumb CMC arthritis. Relaxin hormone increases laxity in the pelvic ligaments through upregulation of matrix metalloproteases (MMPs). It is thus a hormone of interest in the development of thumb CMC arthritis. Questions/purposes Our goals were to identify demographic and hormonal factors associated with joint laxity in patients with CMC arthritis and to evaluate the relationship among serum relaxin, relaxin receptors, and MMPs in the anterior oblique ligament (AOL) of the thumb. We hypothesized that serum relaxin was correlated with joint laxity as well as with relaxin receptors and MMPs in the AOL. MethodsForty-nine patients undergoing thumb CMC arthroplasty underwent laxity examination, blood draw, and AOL sampling. Ligaments were analyzed for relaxin receptor and MMPs 1 and 3 using quantitative reversetranscriptase polymerase chain reaction. Results Women demonstrated more joint laxity than men (p \ 0.001). RNA analysis confirmed relaxin receptors in the AOL as well as MMPs 1 and 3. There was a significant correlation between serum relaxin and MMP-1 (p = 0.04). Detectable serum relaxin was negatively correlated with relaxin receptors in the AOL (p = 0.02). Conclusions Further studies are needed to evaluate the role of laxity and sex hormones in thumb CMC arthritis.

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Section: Discussionmentioning

confidence: 86%

Relationship of Relaxin Hormone and Thumb Carpometacarpal Joint Arthritis

Wolf

Scher

Etchill

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…215,216 This may be particularly important when documenting relaxin exposure. Because relaxin rises and peaks during a relatively short window (6-10 days) after ovulation based on other hormonal events, [217][218][219][220] we do not know if the high proportion of undetectable levels within a single sample (as high as 64%-80%) [221][222][223][224] is due to timing or suggests that only a subset of females are exposed to appreciable relaxin levels due to mediating factors. 219,221,225 5.…”

Section: Good Evidence Demonstrates That Some (But Not All)mentioning

confidence: 99%

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

Shultz

Schmitz

Benjaminse

et al. 2015

Journal of Athletic Training

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“…The first CMC ligament reconstruction technique (Eaton and Littler, 1973) and the subsequent ligament reconstruction tendon interposition (LRTI) (Eaton et al, 1984; Freedman et al, 2000; Tomaino et al, 1995) were partly based on the theory that the CMC joint is kept intact primarily by the AOL. Additionally, the presence of the hormone relaxin, which is associated with ligament loosening, has been found in this ligament and has been correlated with joint laxity (Lubahn et al, 2006; Wolf et al, 2013a, 2013b). Recent studies, however, have reported structural limitations of the AOL that challenge the importance of its role on joint stability (Colman et al, 2007; Hagert et al, 2012; Ladd et al, 2012; Lin et al, 2013; Strauch et al, 1999).…”

Section: Introductionmentioning

confidence: 96%

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

Halilaj

Rainbow

Moore

et al. 2015

Journal of Biomechanics

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The anterior oblique ligament (AOL) and the dorsoradial ligament (DRL) are both regarded as mechanical stabilizers of the thumb carpometacarpal (CMC) joint, which in older women is often affected by osteoarthritis. Inferences on the potential relationship of these ligaments to joint pathomechanics are based on clinical experience and studies of cadaveric tissue, but their function has been studied sparsely in vivo. The purpose of this study was to gain insight into the functions of the AOL and DRL using in vivo joint kinematic data. The thumbs of 44 healthy subjects were imaged with a clinical computed tomography scanner in functional-task and thumb range-of-motion positions. The origins and insertion sites of the AOL and the DRL were identified on the 3D bone models and each ligament was modeled as a set of three fibers whose lengths were the minimum distances between insertion sites. Ligament recruitment, which represented ligament length as a percentage of the maximum length across the scanned positions, was computed for each position and related to joint posture. Mean AOL recruitment was lower than 91% across the CMC range of motion, whereas mean DRL recruitment was generally higher than 91% in abduction and flexion. Under the assumption that ligaments do not strain by more than 10% physiologically, our findings of mean ligament recruitments across the CMC range of motion indicate that the AOL is likely slack during most physiological positions, whereas the DRL may be taut and therefore support the joint in positions of CMC joint abduction and flexion.

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Relationship of Serum Relaxin to Generalized and Trapezial-Metacarpal Joint Laxity

Cited by 27 publications

References 32 publications

Relationship of Relaxin Hormone and Thumb Carpometacarpal Joint Arthritis

Relationship of Relaxin Hormone and Thumb Carpometacarpal Joint Arthritis

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

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