Pisiform Arthritis and Tracking Patterns- a Biomechanical and Histopathological Study

Objective: Pisotriquetral arthritis is a relatively uncommon clinical finding.

Carpal tunnel release has been tied to unmasking of this clinical entity. We conducted a biomechanical and histopathological study assessing the validity of this assertion.

Methods: An apparatus stabilizing the ulna was built and 6 cadaver wrists were brought to a full range of motion while loading the flexor carpi ulnaris prior to and following transverse carpal ligament sectioning. We performed histopathological assessment of pisiform arthritis in 14 specimens utilizing both hematoxylin-and-eosin and toluidine blue. All specimens were graded and staged.

Results: We found transverse carpal ligament severance has no effect on pisotriquetral joint stability in all points along flexor carpi ulnaris excursion and within normal human wrist range of motion. We found a significant difference in grading of osteoarthritis between males and females. Males were found to have more advanced grades of osteoarthritis of the pisiform than females. No correlation was found between age and severity of osteoarthritis grading or staging.

Conclusion: Our findings do no support an effect of transverse carpal ligament to be more abundant in males presumably due to the characteristics of Pisotriquetral joint loading in this patient population.