The goal of this observational study is to learn about the frequency of ATTR amyloid, cardiac involvement and associated features, in 150 patients aged 50 or more years, and operated for an idiopathic carpal tunnel syndrome, lumbar spine stenosis or total hip or knee arthroplasty for primary osteoarthritis. The main questions to be answered are: 1. What is the frequency of ATTR deposits in samples retrieved during surgery? 2. What is the frequency of cardiac involvement in ATTR positive patients? 3. What are the preoperative predictors of ATTR deposits? Participants will * have operative samples stained by Congo red in search of amyloid, which will be typed by immunochemistry in positive samples, * undergo a multimodal imaging search for cardiac involvement, if ATTR is identified, * undergo a preoperative complete clinical examination, including collection of medical history, ECG, biochemical tests, and imaging (ultrasound scans of rotator cuff and hip capsule in all participating patients, of the carpal tunnel in patients operated at this site, and MRI + standing profile radiography of the lumbar spine, in patients operated for lumbar stenosis) * ATTR positive patients will be proposed to be followed-up by a reference center, with the aim of an early diagnosis of cardiac involvement, allowing efficient mamagement. Researchers will assess the frequency of ATTR deposits at each operated site, the frequency or ATTR cardiopathy in ATTR + patients, and will compare demographic, clinical, biochemical, and imaging features in patients with and without ATTR deposits, to guide the indications of pathological examination during these frequent orthopedic surgeries
Study Type
OBSERVATIONAL
Enrollment
150
Mutualist Montsouris Institute
Paris, France
RECRUITINGfrequency of ATTR amyloidosis
presence of ATTR amyloidosis in surgical samples by immunohistochemistry performed when samples countain amyloi by Congo red.ATTR will be semiquantitalively assessed using a published scale.
Time frame: 18 months
presence of ATTR cardiopathy
Diagnosis by multimodal imaging(bone scintigraphy, cardiac US scan, MRI)
Time frame: 20 months
proportion of wild type and hereditary ATTR
hereditary: patients exibit a mutation of the TTR gene, wild type: no mutation. TTR genotyping will determine if the gene is muted (hereditary ATTR) or not (wild type).
Time frame: 20 months
Description of preoperative predictors of ATTR
features more frequent in patients diagnosed with ATTR versus not: \- demographic and clinical characteristics, will be collected before surgery and compared in ATTR positive and ATTR negative patients.
Time frame: 18 months
Description of preoperative predictors of ATTR
features more frequent in patients diagnosed with ATTR versus not: \- imaging characteristics (USscans of rotator cuff, hip capsula and carpal tunel) will be collected before surgery and compared in ATTR positive and ATTR negative patients.
Time frame: 18 months
preoperative predictors of ATTR
biochemical features more frequent in patients diagnosed with ATTR versus not: * troponine (g/L) * BNP (ng/L) * proteuniria (ng/L) will be collected before surgery and compared in ATTR positive and ATTR negative patients.
Time frame: 18 months
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