We performed a histologic evaluation of these two joints to compare their respective innervation in 17 cadaveric specimens with peritrapezial OA. Radiographic scoring confirmed the presence of peritrapezial OA. Mean Kellgren-Lawrence score was 2.2 ± 1.1 in the trapeziometacarpal joint and 1.5 ± 0.7 in the scaphotrapezial joint (p = 0.08).
There was no difference between scaphotrapezial and trapeziometacarpal joints in number of neurofilaments: 5.2 ± 3.9 and 4.4 ± 4.5, respectively (p = 0.20). A significant difference was found in S100 staining (myelinated structures), with a higher rate in the scaphotrapezial joint: 11.8 ± 7.5 vs 6.6 ± 5.2 (p = 0.005).
The present study suggests that lower tolerance of trapeziometacarpal OA is not due to a difference in joint capsule innervation. On the contrary, we found a higher rate of myelinated tissues in the scaphotrapezial joint. These results suggested other pain pathways to explain clinical observations.
方法:我们对这两个关节进行了组织学评估,以比较其在17例尸体标本中的神经支配。X线照相评分证实了周围性OA的存在。平均Kellgren-Lawrence评分在梯形掌骨关节为2.2±1.1,在肩胛骨关节为1.5±0.7(p=0.08)。
结果:肩脑和梯形掌骨之间的神经丝数量没有差异:分别为5.2±3.9和4.4±4.5(p=0.20)。在S100染色(有髓鞘结构)中发现了显着差异,肩胛骨关节的比率较高:11.8±7.5vs6.6±5.2(p=0.005)。
结论:本研究表明,梯形掌骨OA的耐受性较低不是由于关节囊神经支配的差异。相反,我们发现肩胛骨关节有髓鞘组织的比率较高。这些结果提示了其他疼痛途径来解释临床观察。