title: Effect of synovial transthyretin amyloid deposition on preoperative symptoms and postoperative recovery of median nerve function among patients with idiopathic carpal tunnel syndrome.
abstract: BACKGROUND
  The clinical characteristics of wild-type transthyretin amyloid deposition among patients with carpal tunnel syndrome (CTS) have not been well investigated.
  
  
  METHODS
  One-hundred and seven patients with idiopathic CTS who underwent carpal tunnel release were enrolled. They underwent physical examination of the hand, nerve-conduction study, and magnetic resonance imaging (MRI) study of the wrist, and completed a patient-oriented questionnaire. The tests, except for MRI, were repeated 1, 3, and 6 months postoperatively. Synovial tissue was obtained during surgery and analyzed by Congo red and immunohistochemical staining. Ordinal logistic regression analysis was used to evaluate the significance of different clinical and subjective findings between patients with and without amyloid deposition. Postoperative improvements were also compared.
  
  
  RESULTS
  Wild-type transthyretin amyloid deposition was observed for 38 patients. Greater symptom severity and 2-point discrimination scores, and larger cross-sectional areas of the carpal tunnel, were significantly correlated with a larger amount of preoperative amyloid deposition. However, the presence and amount of preoperative amyloid deposition did not affect postoperative improvements in physical findings and nerve-conduction studies.
  
  
  CONCLUSIONS
  Although transthyretin amyloid deposition can worsen CTS symptoms, postoperative improvements were similar for patients with and without this deposition.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan, sigeuti@shinshu-u.ac.jp.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sekijima
authors.forename: Kana
authors.initials: K
authors.lastname: Tojo
authors.forename: Kenji
authors.initials: K
authors.lastname: Sano
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Imaeda
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Moriizumi
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Ikeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000378:metabolism*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008475:Median Nerve / Q000502:physiology*; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D011184:Postoperative Period; D011228:Prealbumin / Q000378:metabolism*; D011300:Preoperative Care; D020127:Recovery of Function / Q000502:physiology*; D013583:Synovial Membrane / Q000378:metabolism* / Q000473:pathology
chemical_list: D000682:Amyloid; D011228:Prealbumin; C041120:amyloid prealbumin