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Effect of synovial transthyretin amyloid deposition on preoperative symptoms and postoperative recovery of median nerve function among patients with idiopathic carpal tunnel syndrome

  • Original Article
  • Published:
Journal of Orthopaedic Science

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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan

    Shigeharu Uchiyama & Hiroyuki Kato

  2. Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, 390-8621, Japan

    Yoshiki Sekijima, Kana Tojo & Shu-ichi Ikeda

  3. Division of Clinical and Molecular Genetics, Shinshu University Hospital, Matsumoto, 390-8621, Japan

    Yoshiki Sekijima

  4. Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, 390-8621, Japan

    Kenji Sano

  5. Department of Food and Nutritional Environment, Kinjo Gakuin University, 2-1723 Ohmori, Moriyama-ku, Nagoya, 463-8521, Japan

    Toshihiko Imaeda

  6. Department of Anatomy, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Tetsuji Moriizumi

Authors
  1. Shigeharu Uchiyama
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  2. Yoshiki Sekijima
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  3. Kana Tojo
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  4. Kenji Sano
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  5. Toshihiko Imaeda
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  6. Tetsuji Moriizumi
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  7. Shu-ichi Ikeda
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  8. Hiroyuki Kato
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Correspondence to Shigeharu Uchiyama.

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Uchiyama, S., Sekijima, Y., Tojo, K. et al. Effect of synovial transthyretin amyloid deposition on preoperative symptoms and postoperative recovery of median nerve function among patients with idiopathic carpal tunnel syndrome. J Orthop Sci 19, 913–919 (2014). https://doi.org/10.1007/s00776-014-0635-y

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  • DOI: https://doi.org/10.1007/s00776-014-0635-y

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