Gerhardt Michael, Johnson Keith, Atkinson Roscoe, Snow Brian, Shaw Colin, Brown Ashley, Vangsness C Thomas
Santa Monica Orthopaedic and Sports Medicine Foundation, Santa Monica, California 90404, USA.
Hip Int. 2012 Jan-Feb;22(1):75-81. doi: 10.5301/HIP.2012.9042.
Hip arthroscopy remains a useful surgical intervention for labral injuries. The literature has predominantly focused on structural and vascular considerations of the hip joint, with few studies examining the neurohistology of the surrounding periarticular tissues. We mapped and identified the periarticular neural anatomy, to identify the presence of sensory nerve fibres and mechanoreceptors within the hip joint. Eight human cadaveric hips were dissected into a total of ten specimens per hip. Histological staining was used to identify neural structures taken from the superolateral, anterior, inferior, and posterior positions of the hip joint. The frozen sections were analyzed by light microscopy to calculate relative concentrations of mean neural fibres per high power field (mnf/hpf). Neural end organs were found in the hip capsule, acetabular labrum, ligamentum teres and transverse acetabular ligament. The highest levels of mechanoreceptors were found in the superolateral aspect of the hip capsule (9.6 mnf/hpf). The labrum showed highest levels of sensory fibres (3.4 mnf/hpf) and mechanoreceptors (4.3mnf/hpf) within the anterior zone. Sensory fibres and mechanoreceptors densely populate the acetabular labrum, capsule and transverse acetabular ligament. The anterior zone of the labrum contained the highest relative concentration of sensory fibres, specifically Ruffini corpuscles.
髋关节镜检查对于盂唇损伤仍然是一种有效的手术干预方法。文献主要集中在髋关节的结构和血管方面的考量,很少有研究探讨周围关节周围组织的神经组织学。我们绘制并确定了关节周围的神经解剖结构,以确定髋关节内感觉神经纤维和机械感受器的存在。对8具人类尸体髋关节进行解剖,每个髋关节共得到10个标本。采用组织学染色来识别取自髋关节上外侧、前侧、下侧和后侧位置的神经结构。通过光学显微镜分析冰冻切片,以计算每个高倍视野中平均神经纤维的相对浓度(mnf/hpf)。在髋关节囊、髋臼盂唇、圆韧带和髋臼横韧带中发现了神经终末器官。在髋关节囊的上外侧发现了最高水平的机械感受器(9.6 mnf/hpf)。盂唇在前区显示出最高水平的感觉纤维(3.4 mnf/hpf)和机械感受器(4.3 mnf/hpf)。感觉纤维和机械感受器密集分布于髋臼盂唇、关节囊和髋臼横韧带。盂唇的前区含有最高相对浓度的感觉纤维,特别是鲁菲尼小体。