Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy…

Cohort studyJournal of hand surgery global online· Sep 2026

Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy Detection: A Systematic Review and African American Retrospective Cohort Study.

Shireen Dogar, Punn Punnakanta, Marcus D Williams … Marc E Walker

OrthopedicsCohort studyDiagnosisQ2IF 1.7

Tenosynovial biopsy found no amyloid deposits in 89 patients undergoing carpal tunnel release.

Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy Detection: A Systematic Review and African American Retrospective Cohort Study.

Shireen Dogar … Marc E Walker

Journal of hand surgery global online · Sep 2026 · Q2 in Orthopedics

Purpose

Performing tenosynovial biopsy during carpal tunnel release (carpal tunnel release) has emerged as a promising diagnostic tool for systemic transthyretin amyloidosis cardiomyopathy (ATTR-CM).

Methods

We reviewed 22 studies published between 2017 and 2025 and conducted a retrospective cohort study of patients who underwent carpal tunnel release at our institution between 2021 and 2025.

n = 89 patients

89

Results

89

no amyloid found, biopsy alone didn't confirm ATTR-CM in this group

n = 89 patients

More results

Our literature review found that 10% to 30% of carpal tunnel release specimens contained amyloid deposits, mass spectrometry was the superior analytic modality, and biopsying the transverse carpal ligament in high-risk patients had greater diagnostic yield.

The mean age was 55.36 ± 12 years and 32.6% were men.

More results

Amyloid deposits were not identified in any specimens.

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Conclusion · 1 of 2

Our negative findings with the largest studied African American population to date underscore the importance of further investigation to refine selection criteria, standardize sampling, and clarify the role of transverse carpal ligament biopsy in early detection of ATTR-CM.

Conclusion · 2 of 2

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy Detection: A Systematic Review and African American Retrospective Cohort Study.

Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy Detection: A Systematic Review and African American Retrospective Cohort Study.

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