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

Study Overview
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Brief Summary
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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.

Detailed Description
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The accessory APL tendons insertions, number of accessory tendons and insertion in trapezium can be a mechanical factor that develop osteophytes and thumb CMC joint osteoarthritis. Antibodies against the general nerve marker protein gene product 9.5 (PGP 9.5) and the glial marker S-100 will be use to depict innervation and corpuscular structures. Innervation pattern and sensory corpuscules were investigated by other authors in the wrist. S-100 immunoreactivity is in the Schwann cells in the central regions of the corpuscle, and PGP 9.5 immunoreactivity marked the axonal structures in the corpuscles. The presence of nerve fascicles and particularly sensory corpuscles in the structures, for exemple capsule and APL insertion near the thumb carpometacarpal joint suggest that these structures in the CMC joint have a propioceptive role in the stability of the joint.

Official Title
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Anatomical Evaluation of the APL and FCR Tendons in Thumb CMC Joint in Relation to Osteophytes Formation of the Trapezium and Osteoarthritis.

Conditions
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Thumb Osteoarthritis

Intervention / Treatment
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* Other: Anatomical dissection and Immunohistochemical techniques


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Specimens: Adults from 50 to 90 years. Exclusion Criteria: Specimens: younger than 50 or older than 90 years.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Anatomical dissection and Immunohistochemical techniques|Anatomical dissection and description|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensory nerve endings and mechanoreceptors in thumb CMC joint | Analyze the types of sensory nerve endings and mechanoreceptors in thumb CMC joint using immunohistochemical techniques: hematoxylin eosin , S100, PGP-95, in order to gain more insight into functional CMC joint stability. Measure in number from 0 to 20 sensory nerve endings. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Thumb Osteoarthritis, Enthesis organ, Sensory nerve endings