Histopathological Characteristics of Stenosing Flexor Tenosynovitis in Diabetic Patients and Possible Associations With Diabetes-Related Variables

Kameyama, M; Chen, Ko-Ron; Mukai, Kiyoshi; Shimada, Akira; Atsumi, Yoshihito; Yanagimoto, Shigeru

doi:10.1016/j.jhsa.2013.03.049

Cited by 24 publications

(19 citation statements)

References 21 publications

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“…In a clinical study with ultrasound examination, the calcifications localized at the enthesis of the Achilles tendons were found in asymptomatic patients with diabetes [8]. What's more, the significant increase of fibrocartilage metaplasia and granulation tissue hyperplasia were reported in patients with diabetes with stenosing flexor tenosynovitis compared to those subjects without diabetes [39]. Local hypoxia, which is induced by rupture of collagen fibers, and disturbance of microcirculation, may contribute to calcifications [24].…”

Section: Histopathological Changes Gross Observation and Histologicalmentioning

confidence: 98%

“…In the diabetic patients with stenosing flexor tenosynovitis, the presence of a small number of inflammatory cells was found in the hyperplastic granulation tissue [39]. In the diabetic rats, a higher accumulation of nitrite/nitrate (NOx) was also found indicating chronic inflammatory status in the diabetic tendons [37].…”

Section: Inflammatory Responsesmentioning

confidence: 99%

“…Reduced inflammatory response in the injured diabetic tendons might account for the impaired normal tendon healing capacity in DM condition. Chronic inflammatory status was found in the DM condition, and this might be one of the proper reasons for the tendons' alternations in DM [37,39]. Many studies also demonstrated that inflammatory enzymes, cytokines and reactive oxygen species (ROS) contribute to cell death and many diseases [49].…”

Section: Inflammatory Responsesmentioning

confidence: 99%

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Alterations of tendons in diabetes mellitus: what are the current findings?

Shi

Menemenlis

et al. 2015

International Orthopaedics (SICOT)

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As a connective tissue, tendon connects the muscle and bone, and plays the key role in the locomotor system. Some previous studies have shown the pathological alternations in diabetic tendons, which might result in the structural and functional changes, and even accelerate the process of diabetic foot. In this review, we examined the current findings of the diabetic tendons in the form of various aspects, and summarized the clinical presentation, imaging, biomechanical, histopathological, cellular and molecular abnormalities in the diabetic tendons. The progress of diabetic tendon damage is complicated and the main hypotheses include the excessive accumulation of AGEs, the altered inflammatory response, neovascularization and insensitive neuropathy. However, the cellular and molecular mechanisms of these alterations are still ambiguous. Tendon stem/progenitor cells (TSPCs) have been discovered to play important roles in both tendon physiology and tendon pathology. Recently, we identified TSPCs from patellar tendons in our well-established diabetic rat model and found impaired tenogenic differentiation potential of these cells. We proposed a new hypothesis that the impaired cell functions of diabetic TSPCs might be the underlying cellular and molecular mechanism of the diabetic tendon alternations. These findings should be helpful to establish a better therapeutic strategy for diabetic tendon repair and regeneration.

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Section: Histopathological Changes Gross Observation and Histologicalmentioning

confidence: 98%

Section: Inflammatory Responsesmentioning

confidence: 99%

Section: Inflammatory Responsesmentioning

confidence: 99%

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Alterations of tendons in diabetes mellitus: what are the current findings?

Shi

Menemenlis

et al. 2015

International Orthopaedics (SICOT)

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“…4 Previous studies have reported a 10 to 20% higher incidence of trigger finger in diabetic patients and a higher likelihood of multiple digit involvement than a non-diabetic patient. 5,6,7,8 With prior data indicating only moderate long-term relief (36–60%) after corticosteroid injections for trigger finger in diabetic patients, the risks of injection must be weighed against potential benefits. 1,9,10 …”

Section: Introductionmentioning

confidence: 99%

Blood Glucose Levels in Diabetic Patients Following Corticosteroid Injections Into the Hand and Wrist

Stepan¹,

London²,

Boyer³

et al. 2014

The Journal of Hand Surgery

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Purpose To quantify diabetic patients’ change in blood glucose levels after corticosteroid injection for common hand diseases and to assess which patient-level risk factors may predict an increase in blood glucose levels. Methods Patients were recruited for this case-crossover study in the clinic of fellowship-trained hand surgeons at a tertiary care center. Patients with diabetes mellitus type 1 or 2 receiving a corticosteroid injection recorded their morning fasting blood glucose levels for 14 days after their injection. Fasting glucose levels on days 1–7 after injection qualified as “case” data with levels on days 10–14 providing control data. A mixed model with a priori contrasts were used to compare post-injection blood glucose levels to baseline levels. A linear regression model was used to determine patient predictors of a post-injection rise in blood glucose levels. Results Forty of 67 patients (60%) recruited for the study returned completed blood glucose logs. There was a significant increase in fasting blood glucose levels following injection limited to post-injection days 1 and 2. Among patient risk factors in our linear regression model, type 1 diabetes and use of insulin each predicted a post-injection increase in blood glucose levels from baseline while higher HbA1c levels did not predict increases. Discussion Corticosteroid injections in the hand transiently increase blood glucose levels in diabetic patients. Patients with type 1 diabetes and insulin-dependent diabetics are more likely to experience this transient rise in blood glucose levels. Level of Evidence Therapeutic Level III

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“…Age and sex were the most common comparisons. Duration of disease, disease classification, disease severity, and hand dominance were also frequently compared characteristics (20, 21, 29, 30). …”

Section: Resultsmentioning

confidence: 99%

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

Johnson¹,

Malay²,

Chung³

2015

The Journal of Hand Surgery

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Purpose To evaluate control group selection in non-randomized studies published in the Journal of Hand Surgery American (JHS). Methods We reviewed all papers published in JHS in 2013 to identify studies that used non-randomized control groups. Data collected included type of study design and control group characteristics. We then appraised studies to determine if authors discussed confounding and selection bias and how they controlled for confounding. Results Thirty-seven non-randomized studies were published in JHS in 2013. The source of control was either the same institution as the study group, a different institution, a database, or not provided in the manuscript. Twenty-nine (78%) studies statistically compared key characteristics between control and study group. Confounding was controlled with matching, exclusion criteria, or regression analysis. Twenty-two (59%) papers explicitly discussed the threat of confounding and 18(49%) identified sources of selection bias. Conclusions In our review of non-randomized studies published in JHS, papers had well-defined controls that were similar to the study group, allowing for reasonable comparisons. However, we identified substantial confounding and bias that were not addressed as explicit limitations, which might lead the reader to overestimate the scientific validity of the data. Clinical relevance Incorporating a brief discussion of control group selection in scientific manuscripts should help readers interpret the study more appropriately. Authors, reviewers, and editors should strive to address this component of clinical importance.

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Histopathological Characteristics of Stenosing Flexor Tenosynovitis in Diabetic Patients and Possible Associations With Diabetes-Related Variables

Cited by 24 publications

References 21 publications

Alterations of tendons in diabetes mellitus: what are the current findings?

Alterations of tendons in diabetes mellitus: what are the current findings?

Blood Glucose Levels in Diabetic Patients Following Corticosteroid Injections Into the Hand and Wrist

The Quality of Control Groups in Nonrandomized Studies Published in the Journal of Hand Surgery

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