Anatomical Evaluation of the APL Tendons in Thumb CMC Joint and Osteoarthritis

NCT05626192 | Unknown

• 1 other identifier: IIBSP-CMC-2022-69
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 2

Brief Summary

Certain ligaments in the human body are designed to be a static stabilizer and others to have a sensory function thus remains an unresolved issue. The presence of mechanoreceptors (sensory corpuscles and free nerve endins) in the human knee and ankle ligaments has implies a sensory role of ligaments in providing afferent information, which in turn regulates intrinsic stiffness in the muscles surrounding the joint, contribuiting to dynamic joint stability. The aim of this study is to use immunohistochemical methods to analyze the general innervation and possible existence of sensory corpuscles in the thumb carpometacarpal (CMC) joint. This study can help to know the contribution of the tendon insertions and ligaments in the dynamic thumb CMC joint stability.

Conditions

Thumb Osteoarthritis

Keywords

Thumb Osteoarthritis; Enthesis organ; Sensory nerve endings

Outcome Measures

Primary Outcomes (2)

• Number of APL tendon insertions in trapezium in thumb CMC joint

  Description of the distribution of the APL tendons in thumb CMC joint. Measure in number from 1 to 10 insertions.

  12 months

• Osteophytes formation and thumb CMC joint osteoarthritis (OA)

  Thumb carpometacarpal joint osteoarthitis and osteophytes. Classifying the thumb OA in the specimens according to the International Cartilage Repair Society (ICRS) cartilage lesion classification system. Measure of the loss of cartilage in the CMC joint surface in millimeters (mm) with a digital caliper.

  12 months

Secondary Outcomes (1)

• Sensory nerve endings and mechanoreceptors in thumb CMC joint

  12 months

Interventions

Anatomical dissection and Immunohistochemical techniques OTHER

Anatomical dissection and description

Eligibility Criteria

• Age: 50 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The present study will include 20 specimens. The first part of the study will be a dissection of the specimens. Description of the variability of tendons in the first extensor compartment. The investigators analyze the APL tendon insertion, osteophytes formation and osteoarthritis in thumb CMC joint . In the second part of the study, the researchers will take a small sample of the APL insertion with the osteophyte, capsule and ligaments in the thumb CMC joint. The investigators will fix the sample in a solution of 4% formaldehyde and they will stain the samples with hematoxylin eosin. Immunohistochemistry with PGP 9.5 and S-100.

You may qualify if:

• Specimens: Adults from 50 to 90 years.

You may not qualify if:

• Specimens: younger than 50 or older than 90 years.

Sponsors & Collaborators

• Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau: lead

Study Sites (2)

Claudia Erika Delgado Espinoza

Barcelona, 08025, Spain

RECRUITING

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025, Spain

RECRUITING

Related Publications (17)

• Adams JE, O'Brien V, Magnusson E, Rosenstein B, Nuckley DJ. Radiographic Analysis of Simulated First Dorsal Interosseous and Opponens Pollicis Loading Upon Thumb CMC Joint Subluxation: A Cadaver Study. Hand (N Y). 2018 Jan;13(1):40-44. doi: 10.1177/1558944717691132. Epub 2017 Feb 16.

  PMID: 28719976 RESULT

• Choi SY, Rhim J, Han WJ, Park H, Noh JW, Han J, Ha CW. Associations between biomarkers and histological assessment in individual animals in a destabilization of the medial meniscus (DMM) model of osteoarthritis (OA). Acta Orthop Belg. 2021 Dec;87(4):713-721. doi: 10.52628/87.4.16.

  PMID: 35172438 RESULT

• Deivasigamani S, Azad A, Yang SS. The Variable Insertional Anatomy of the Abductor Pollicis Longus: Functional Relevance and Relationship to Adjacent Thumb Extensors. Hand (N Y). 2023 Jan;18(1):145-152. doi: 10.1177/1558944721999734. Epub 2021 Apr 1.

  PMID: 33789520 RESULT

• Gupta S, Michelsen-Jost H. Anatomy and function of the thenar muscles. Hand Clin. 2012 Feb;28(1):1-7. doi: 10.1016/j.hcl.2011.09.006.

  PMID: 22117918 RESULT

• Freeman MA, Wyke B. The innervation of the ankle joint. An anatomical and histological study in the cat. Acta Anat (Basel). 1967;68(3):321-33. doi: 10.1159/000143037. No abstract available.

  PMID: 5591904 RESULT

• Hagert E, Lee J, Ladd AL. Innervation patterns of thumb trapeziometacarpal joint ligaments. J Hand Surg Am. 2012 Apr;37(4):706-714.e1. doi: 10.1016/j.jhsa.2011.12.038.

  PMID: 22464234 RESULT

• 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 Jan;32(1):30-6. doi: 10.1016/j.jhsa.2006.10.005.

  PMID: 17218173 RESULT

• Hagert E, Ljung BO, Forsgren S. General innervation pattern and sensory corpuscles in the scapholunate interosseous ligament. Cells Tissues Organs. 2004;177(1):47-54. doi: 10.1159/000078427.

  PMID: 15237195 RESULT

• Kofman KE, Schuurman AH, Mulder MC, Verlinde SA, Gierman LM, van Diest PJ, Bleys RL. The pisotriquetral joint: osteoarthritis and enthesopathy. J Hand Microsurg. 2014 Jun;6(1):18-25. doi: 10.1007/s12593-014-0129-3. Epub 2014 Apr 18.

  PMID: 24876685 RESULT

• 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 Aug 15;94(16):1468-77. doi: 10.2106/JBJS.K.00329.

  PMID: 22992815 RESULT

• McGee C, O'Brien V, Van Nortwick S, Adams J, Van Heest A. First dorsal interosseous muscle contraction results in radiographic reduction of healthy thumb carpometacarpal joint. J Hand Ther. 2015 Oct-Dec;28(4):375-80; quiz 381. doi: 10.1016/j.jht.2015.06.002. Epub 2015 Jun 27.

  PMID: 26209165 RESULT

• Menz HB, Marshall M, Thomas MJ, Rathod-Mistry T, Peat GM, Roddy E. Associations Between Calcaneal Enthesophytes and Osteoarthritis of the Hands and Feet. Arthritis Care Res (Hoboken). 2020 Oct;72(10):1343-1348. doi: 10.1002/acr.24030.

  PMID: 31325208 RESULT

• Moriggl B, Kumai T, Milz S, Benjamin M. The structure and histopathology of the "enthesis organ" at the navicular insertion of the tendon of tibialis posterior. J Rheumatol. 2003 Mar;30(3):508-17.

  PMID: 12610810 RESULT

• Opreanu RC, Wechter J, Tabbaa H, Kepros JP, Baulch M, Xie Y, Lackey W, Katranji A. Anatomic variations of the first extensor compartment and abductor pollicis longus tendon in trapeziometacarpal arthritis. Hand (N Y). 2010 Jun;5(2):184-9. doi: 10.1007/s11552-009-9234-3. Epub 2009 Oct 16.

  PMID: 19834771 RESULT

• Rein S, Hagert E, Hanisch U, Lwowski S, Fieguth A, Zwipp H. Immunohistochemical analysis of sensory nerve endings in ankle ligaments: a cadaver study. Cells Tissues Organs. 2013;197(1):64-76. doi: 10.1159/000339877. Epub 2012 Sep 4.

  PMID: 22964904 RESULT

• Rein S, Krenn V, Hagert E, Garcia-Elias M, Lluch A, Kremer T, Semisch M. Degeneration of the articular disc in the human triangular fibrocartilage complex. Arch Orthop Trauma Surg. 2021 Apr;141(4):699-708. doi: 10.1007/s00402-021-03795-2. Epub 2021 Feb 6.

  PMID: 33550482 RESULT

• Wu Z, Nagata K, Iijima T. Involvement of sensory nerves and immune cells in osteophyte formation in the ankle joint of adjuvant arthritic rats. Histochem Cell Biol. 2002 Sep;118(3):213-20. doi: 10.1007/s00418-002-0443-x. Epub 2002 Jul 19.

  PMID: 12271357 RESULT

Study Officials

• Claudia Lamas, MD, Ph D

  Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Claudia Lamas, MD, Ph D

CONTACT

935537032; clamasg@santpau.cat

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 15, 2022
• First Posted: November 23, 2022
• Study Start: November 13, 2022
• Primary Completion: August 16, 2024
• Study Completion: December 23, 2024
• Last Updated: March 21, 2024

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will not share

Locations

ES (2)