Tendon Injury Produces Changes in SSCT and Nerve Physiology Similar to Carpal Tunnel Syndrome in an in Vivo Rabbit Model

Moriya, Tamami; Zhao, Chunfeng; Stephen, S.; Schmelzer, James D.; Low, Phillip A.; An, Kai Nan; Amadio, Peter C.

doi:10.1007/s11552-011-9356-2

Cited by 19 publications

(26 citation statements)

References 23 publications

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“…Similar observations have been made in CTS animal models (Moriya et al, 2011; Vanhees et al, 2013; Yoshii et al, 2009b). Results of this study do, however, refine the analysis, allowing for a more detailed description of how the mechanical behavior is different.…”

Section: Discussionsupporting

confidence: 85%

Development of a hyperelastic material model of subsynovial connective tissue using finite element modeling

Matsuura

Thoreson

Zhao

et al. 2016

Journal of Biomechanics

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Carpal tunnel syndrome (CTS) is one of the most common disorders of the hand. Assessment of carpal tunnel tissue mechanical behavior, especially that of the subsynovial connective tissue (SSCT), is important to better understand the mechanisms of CTS. The aim of this study was to develop a hyperelastic material model of human SSCT using mechanical test data and finite element modeling (FEM). Experimental shear test data of SSCT from 7 normal subjects and 7 CTS patients, collected in a prior study was used to define material response. Hyperelastic coefficients (μ and α) from the first-order Ogden material property definition were iteratively solved using specimen-specific FEM models simulating the mechanical test conditions. A typical Ogden hyperelastic response for the normal and CTS SSCT was characterized by doing the same with data from all samples averaged together. The mean Ogden coefficients (μ / α) for the normal cadaver and CTS patient SSCT were 1.25×10−5 MPa / 4.51 and 1.99×10−6 MPa / 10.6, respectively when evaluating coefficients for individual specimens. The Ogden coefficients for the typical (averaged data) model for normal cadaver and CTS patient SSCT were 1.63×10−5 MPa / 3.93 and 5.00×10−7 MPa / 9.55, respectively. Assessment of SSCT mechanical response with a hyperelastic material model demonstrated significant differences between patient and normal cadaver. The refined assessment of these differences with this model may be important for future model development and in understanding clinical presentation of CTS.

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Section: Discussionsupporting

confidence: 85%

Development of a hyperelastic material model of subsynovial connective tissue using finite element modeling

Matsuura

Thoreson

Zhao

et al. 2016

Journal of Biomechanics

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“…Based on previous studies [10,18], a sample size of 12 was needed in the mechanical testing group, and 25 were needed for EP testing. We estimated that eight specimens would be needed for histology and noted that the preparations for routine staining, nerve histology, and EM all required different fixation and so could not all be done on the same specimens.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Time after Shear Injury on the Subsynovial Connective Tissue and Median Nerve within the Rabbit Carpal Tunnel

Vanhees

Chikenji

Thoreson

et al. 2012

Hand (New York, N,Y.)

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Background The most prominent nonneurological finding in the common compression neuropathy carpal tunnel syndrome (CTS) is fibrosis of the subsynovial connective tissue (SSCT). Recently, a rabbit model of CTS has been developed, based on the hypothesis that SSCT injury and subsequent fibrosis cause nerve compression. The purpose of this study was to evaluate the effects in this model at earlier and later time points than have heretofore been reported. Methods Sixty rabbits were operated on and observed at two different time periods: 6 and 24 weeks. Nerve electrophysiology (EP), SSCT histology, and SSCT mechanical properties were assessed. Results There was no significant difference in median motor nerve amplitude or latency at either time point. The total cell density in the SSCT was significantly higher at 6 and 24 weeks compared to controls. The mean size of the collagen fibrils in the SSCT was higher 6 and 24 weeks after surgery compared to controls. Both the ultimate load and the total energy absorption of the SSCT were significantly higher at 6 and 24 weeks compared to controls. Conclusions In this model, there were signs of SSCT fibrosis and histology changes at 6 weeks, which persist after 24 weeks. Thus, this model leads to sustained SSCT fibrosis, which is one characteristic of human CTS. However, no significant EP changes were found at these two time points, which is in contrast to the findings reported previously for this model at 12 weeks. The significance of the differences in EP findings will be the subject of future studies.

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“…The rabbits were evenly divided into 2 groups for either skin incision alone or skin incision with tendon laceration and SSCT stretching. 13 Nine other rabbits, without any intervention at their wrists, were obtained from other studies in our institution to serve as a normal control group.…”

Section: Methodsmentioning

confidence: 99%

“…13 In this model, a shear injury of the SSCT is created by surgically stretching the SSCT beyond its elastic limit. 14 Rabbits with this injury developed median neuropathy, similar to that seen in human CTS.…”

Section: Introductionmentioning

confidence: 99%

Subsynovial connective tissue is sensitive to surgical interventions in a rabbit model of carpal tunnel syndrome

Sun

Moriya

Zhao

et al. 2011

Journal Orthopaedic Research

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The most common histological finding in carpal tunnel syndrome (CTS) is non-inflammatory fibrosis and thickening of the subsynovial connective tissue (SSCT) in the tunnel. While the cause of SSCT fibrosis and the relationship of SSCT fibrosis and CTS are unknown, one hypothesis is that SSCT injury causes fibrosis, and that the fibrosis then leads to CTS. We investigated the sensitivity of the SSCT to injuries. Two types of surgical intervention were performed in a rabbit model: a skin incision with tendon laceration and SSCT stretching sufficient to damage the SSCT, and skin incision alone,. Twelve weeks after surgery, the rabbit carpal tunnel tissues were studied with immunochemistry for TGF-β receptors 1, 2, and 3, collagen III, and collagen VI. All TGF-β receptors were expressed. The percentages of the TGF-β receptors’ expressions were less in the control SSCT fibroblasts than in the fibroblasts from rabbits with surgical interventions. The surgical interventions did not result in any alteration of collagen III expression. However, both surgical interventions resulted in a significant decrease in collagen VI expression compared to the control group. The two surgical interventions achieved similar expression of TGF-β receptors and collagens. Our results provide evidence that the SSCT is sensitive to surgical interventions, even when these are modest. Since SSCT fibrosis is a hallmark of carpal tunnel syndrome, these data also suggest that such fibrosis could result from relatively minor trauma.

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Tendon Injury Produces Changes in SSCT and Nerve Physiology Similar to Carpal Tunnel Syndrome in an in Vivo Rabbit Model

Cited by 19 publications

References 23 publications

Development of a hyperelastic material model of subsynovial connective tissue using finite element modeling

Development of a hyperelastic material model of subsynovial connective tissue using finite element modeling

The Effect of Time after Shear Injury on the Subsynovial Connective Tissue and Median Nerve within the Rabbit Carpal Tunnel

Subsynovial connective tissue is sensitive to surgical interventions in a rabbit model of carpal tunnel syndrome

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