Prantil, Ryan/RKP
(2012)
THE STRUCTURE OF THE TRANSVERSE CARPAL LIGAMENT: ITS COLLAGEN FIBER ORIENTATION AND THE EFFICACY OF COLLAGENASE IN DECREASING ITS STIFFNESS.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Carpal tunnel syndrome (CTS) currently affects more than three million Americans each
year. Hand surgeons treat CTS by targeting the transverse carpal ligament (TCL) which acts as
the palmar roof of the carpal tunnel. Based on general observation, the TCL appears to be an
inextensible collagenous matrix with fibers roughly oriented along the transverse direction.
Several studies on the TCL’s configuration argue for different fiber orientations consisting of
either oblique or transverse orientations; whereas, most findings were based on an
observational methodology. Very few studies have determined such fiber orientations;
whereas, even fewer studies have researched the ligament’s mechanical properties.
Furthermore, the potential of altering the TCL’s microstructure may provide a potential,
alternative to the currently accepted, invasive standards.
Previous studies attempting to lengthen the TCL found that such procedures can effectively
diminish CTS symptoms and also decrease the progression of several post-operative
complications. However, these procedures consist of transecting the transverse carpal ligament
in an attempt to increase its length. Furthermore, mechanical stimuli cannot alter the ligament
because it is too stiff. In addition, such procedures also require invasive surgery and can cause
complications that arise from carpal tunnel release. Therefore, a solution might lie in the
application of collagenase where antecedent works have shown its capacity to reduce the
v
mechanical properties of a tissue.
The following studies have emphasized the transverse carpal ligament’s collagen
orientation and its mechanical response to subsequent collagenase treatment. The preferential
collagen direction was quantified through the use of small angle light scattering (SALS).
Results showed that transverse orientation was the most prevalent with minimal changes found
within its orientation along its thickness. As for the TCL’s response to collagenase, standard
concentrations of collagenase were applied to the TCL for each specimen through successive
mechanical loading protocols along with successive observations to analyze the progressive
changes within the ligament by slowly eliminating its collagen network. Collagenase
effectively decreased the transverse carpal ligament’s stiffness without significantly changing
its mechanical properties. Furthermore, these studies could contribute to a more sophisticated
model of the TCL and lead to the development of a minimally invasive therapy contrary to
current, invasive standards.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
30 January 2012 |
| Date Type: |
Publication |
| Defense Date: |
12 July 2011 |
| Approval Date: |
30 January 2012 |
| Submission Date: |
22 November 2011 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
101 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
Swanson School of Engineering > Bioengineering |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Carpal Tunnel Mechanics
Carpal Tunnel Syndrome
Collagenase
Collagen Fiber Orientation
Small Angle Light Scattering
Transverse Carpal Ligament |
| Related URLs: |
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| Date Deposited: |
30 Jan 2012 20:51 |
| Last Modified: |
15 Nov 2016 13:55 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/10541 |
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