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Adamczyk, Christopher (2008): Die Zusammensetzung der extrazellulären Matrix der Sehnen- und Bandansätze am Os pisiforme. Dissertation, LMU München: Medizinische Fakultät



According to recently published studies two types of entheses are discussed, a fibrous and a fibrocartilaginous one. The fibrous enthesis is seen transmitting only tensile forces of muscle to the bone, while the fibrocartilaginous enthesis in addition is also seen dissipating stress away from the hard- soft- tissue- interface. The pisiforme bone in its role as a bony pulley (Hypomochlion) splits the force of the m. flexor carpi ulnaris on two ligaments. One of those is running in line of the tendon from the m. flexor carpi ulnaris, while the other branch is running in an angle of 45° according to them. The aim of the present study is to describe the molecular composition of the insertions from the pisiforme bone, expecting both types of entheses. Eleven pisiform bones are taken from bodies at the latest 48h post mortem. They were fixed in methanol, decalcified and cryosectioned. Sections were labelled with monoclonal antibodies directed against collagens, glycosaminoglycans proteoglycans and other specific matrixproteins. All attachment sites showed fibrocartilaginous entheses. Typically these zones of fibrocartilage are labelling strongly for type II collagen, aggrecan and link- protein. The ligaments themselves are labelling for collagen type I and III, chondroitin 4 sulfate, keratan and dermatan sulfate, versican and tenascin. The area of the fibrocartilaginuos region is varying between the entheses, which is interpreted as functional adaptation to the prevailing forces.