Susanne Rein1,2, Veit Krenn3, Elisabet Hagert4,5,6, Marc Garcia-Elias7,8, Alex Lluch7,8, Thomas Kremer9, Manuel Semisch10. 1. Department of Plastic and Hand Surgery, Burn Unit, Klinikum Sankt Georg, Delitzscher Straße 141, Leipzig, Germany. susanne.rein@web.de. 2. Martin-Luther-University of Halle-Wittenberg, Halle, Germany. susanne.rein@web.de. 3. Medizinisches Versorgungszentrum für Histologie, Zytologie und Molekulare Diagnostik Trier, Max-Planck-Str. 5, Düren, Düsseldorf, 54296, Trier, Germany. 4. Arcademy, H.M Queen Sophia Hospital, Stockholm, Sweden. 5. Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden. 6. Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden. 7. Institut Kaplan Hand and Upper Extremity Surgery, Avenida Josep Vicenç Foix 71, 08034, Barcelona, Spain. 8. Departamento de Anatomía, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain. 9. Department of Plastic and Hand Surgery, Burn Unit, Klinikum Sankt Georg, Delitzscher Straße 141, Leipzig, Germany. 10. Sächsischen Krankenhaus Altscherbitz, Department of Neurology, Leipziger Straße 59, 04435, Schkeuditz, Germany.
Abstract
INTRODUCTION: Traumatic injuries of the triangular fibrocartilage complex (TFCC) are frequent reasons for ulnar wrist pain. The assessment of the extent of articular disc (AD) degeneration is important for the differentiation of acute injuries versus chronic lesions. MATERIALS AND METHODS: The AD of the TFCC of eleven human cadaver wrists was dissected. Degeneration was analyzed according to the grading of Krenn et al. Hematoxylin-eosin was used to determine the tissue morphology. Degeneration was evaluated using the staining intensity of alcian blue, the immunohistochemistry of the proteoglycan versican and the immunoreactivity of NITEGE, an aggrecan fragment. RESULTS: The staining homogeneity of HE decreased with higher degeneration of the AD and basophilic tissue areas were more frequently seen. Two specimens were characterized as degeneration grade 1, five specimens as grade 2, and four specimens as grade 3, respectively. Staining intensity of alcian blue increased with higher degeneration grade of the specimens. Immunoreactivity for NITEGE was detected around tissue fissures and perforations as well as matrix splits. Immunoreactivity for versican was found concentrated in the tissue around matrix fissures and lesions as well as loose connective tissue at the ulnar border of the AD. Specimens with degeneration grade 2 had the strongest immunoreactivity of NITEGE and versican. Cell clusters were observed in specimens with degeneration grade 2 and 3, which were stained by alcian blue and immunoreactive for NITEGE and versican. Increasing age of the cadaver wrists correlated with a higher degree of degeneration (p < 0.0001, r = 0.68). CONCLUSIONS: The fibrocartilage of degenerated ADs contains NITEGE and versican. The amount of the immunoreactivity of these markers allows the differentiation of degenerative changes into three grades. The degeneration of the AD increases with age and emphasizes its important mechanical function.
INTRODUCTION: Traumatic injuries of the triangular fibrocartilage complex (TFCC) are frequent reasons for ulnar wrist pain. The assessment of the extent of articular disc (AD) degeneration is important for the differentiation of acute injuries versus chronic lesions. MATERIALS AND METHODS: The AD of the TFCC of eleven human cadaver wrists was dissected. Degeneration was analyzed according to the grading of Krenn et al. Hematoxylin-eosin was used to determine the tissue morphology. Degeneration was evaluated using the staining intensity of alcian blue, the immunohistochemistry of the proteoglycan versican and the immunoreactivity of NITEGE, an aggrecan fragment. RESULTS: The staining homogeneity of HE decreased with higher degeneration of the AD and basophilic tissue areas were more frequently seen. Two specimens were characterized as degeneration grade 1, five specimens as grade 2, and four specimens as grade 3, respectively. Staining intensity of alcian blue increased with higher degeneration grade of the specimens. Immunoreactivity for NITEGE was detected around tissue fissures and perforations as well as matrix splits. Immunoreactivity for versican was found concentrated in the tissue around matrix fissures and lesions as well as loose connective tissue at the ulnar border of the AD. Specimens with degeneration grade 2 had the strongest immunoreactivity of NITEGE and versican. Cell clusters were observed in specimens with degeneration grade 2 and 3, which were stained by alcian blue and immunoreactive for NITEGE and versican. Increasing age of the cadaver wrists correlated with a higher degree of degeneration (p < 0.0001, r = 0.68). CONCLUSIONS: The fibrocartilage of degenerated ADs contains NITEGE and versican. The amount of the immunoreactivity of these markers allows the differentiation of degenerative changes into three grades. The degeneration of the AD increases with age and emphasizes its important mechanical function.
Authors: Frank Unglaub; Peter Hahn; Elke Wolf; Guenter Germann; Berthold Bickert; Michael Sauerbier Journal: Ann Plast Surg Date: 2007-11 Impact factor: 1.539
Authors: Susanne Rein; Manuel Semisch; Marc Garcia-Elias; Alex Lluch; Hans Zwipp; Elisabet Hagert Journal: Clin Orthop Relat Res Date: 2015-05-30 Impact factor: 4.176
Authors: V Krenn; P Knöss; W Rüther; M Jakobs; M Otto; M G Krukemeyer; A Heine; G Möllenhoff; B Kurz Journal: Orthopade Date: 2010-05 Impact factor: 1.087
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