title: Altered Innervation Pattern in Ligaments of Patients with Basal Thumb Arthritis.
abstract: Purpose The population of mechanoreceptors in patients with osteoarthritis (OA) lacks detailed characterization. In this study, we examined the distribution and type of mechanoreceptors of two principal ligaments in surgical subjects with OA of the first carpometacarpal joint (CMC1). Methods We harvested two ligaments from the CMC1 of eleven subjects undergoing complete trapeziectomy and suspension arthroplasty: the anterior oblique (AOL) and dorsal radial ligament (DRL). Ligaments were divided into proximal and distal portions, paraffin-sectioned, and analyzed using immunoflourescent triple staining microscopy. We performed statistical analyses using the Wilcoxon Rank Sum test and ANOVA with post-hoc Bonferroni and Tamhane adjustments. Results The most prevalent nerve endings in the AOL and DRL of subjects with OA were unclassifiable mechanoreceptors, which do not currently fit into a defined morphological scheme. These were found in 11/11 (100%) DRLs and 7/11 (63.6%) AOLs. No significant difference existed with respect to location within the ligament (proximal versus distal) of mechanoreceptors in OA subjects. Conclusion The distribution and type of mechanoreceptors in cadavers with no to mild OA differ from those in surgical patients with OA. Where Ruffini endings predominate in cadavers with no to mild OA, unclassifiable corpuscles predominate in surgical patients with OA. These findings suggest an alteration of the mechanoreceptor population and distribution that accompanies the development of OA. Clinical Relevance Identification of a unique type and distribution of mechanoreceptors in the CMC1 of symptomatic subjects provides preliminary evidence of altered proprioception in OA.
authors.affiliation: Department of Orthopaedic Surgery, Robert A. Chase Hand and Upper Limb Center, Stanford University, Palo Alto, California.
authors.forename: Cassie A
authors.initials: CA
authors.lastname: Ludwig
authors.affiliation: Department of Hand and Plastic Surgery, Stavanger University Hospital, Stavanger, Norway ; Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Mobargha
authors.affiliation: Department of Orthopaedic Surgery, Robert A. Chase Hand and Upper Limb Center, Stanford University, Palo Alto, California.
authors.forename: Janet
authors.initials: J
authors.lastname: Okogbaa
authors.affiliation: Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden ; Hand and Foot Surgery Center, Stockholm, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Hagert
authors.affiliation: Department of Orthopaedic Surgery, Robert A. Chase Hand and Upper Limb Center, Stanford University, Palo Alto, California.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ladd
keywords: carpometacarpal; innervation; joint; osteoarthritis; proprioception; trapeziometacarpal