Gohlke F, Janßen E, Leidel J, Heppelmann B, Eulert J
Orthopädische Universitätsklinik, König-Ludwig-Haus, Universität Würzburg •, Germany.
Institut für Physiologie, Universität Würzburg, Germany.
Orthopade. 1998 Sep;27(8):510-517. doi: 10.1007/PL00003524.
Purpose of this study was the evaluation of distribution and morphology of mechanoreceptors in the glenohumeral joint capsule and rotator cuff in comparison to the coracoacromial ligament by means of specific immunfluorescence microscopy. The complemente joint capsules, rotator cuffs and coracoacromial ligaments of three fresh cadaver shoulder were harvested. Serial cryostate sections were taken and alternately incubated with antiserum against neurofilament, lamin or myelin of peripheral nerves. The antibody-reaction was visualized with fluorescin Ig-G. The nerve endings were photographed and computer-aided 3-dimensional reconstructions were performed. Three types of corpuscular and free nerve endings of different morphology were found in different distributions: whereas the Ruffini corpuscles were much more frequent in the coracoacromial ligament and rotator cuff, Pacini endings were predominantly found in the joint capsule. Generally corpuscular nerve endings were more frequent in the coracoacromial ligament and the rotator cuff than in the antero-inferior capsule and the number of corpuscles increased from medial to lateral within the anterior and inferior parts of the capsule. The dense ligamentous tissue was almost aneural whereas the periarticular fatty or loose connective tissue contained nerve fibres and nerve endings. In view of the results of other experimental and clinical studies the high frequency of Ruffini and Pacini endings in the rotator cuff and coracoacromial ligament suggest, that both are involved in the neurosensory control of glenohumeral stability and subacromial impingement. In contrast our findings in the joint capsule do not clearly proove, that those joint receptors predominantly maintain joint stability.
本研究的目的是通过特异性免疫荧光显微镜，比较肩肱关节囊和肩袖与喙肩韧带中机械感受器的分布和形态。采集了三具新鲜尸体肩部的关节囊、肩袖和喙肩韧带。制作连续冰冻切片，并交替用抗周围神经神经丝、层粘连蛋白或髓磷脂的抗血清孵育。用荧光素Ig-G显示抗体反应。拍摄神经末梢照片并进行计算机辅助三维重建。在不同分布中发现了三种形态不同的球状体和游离神经末梢：鲁菲尼小体在喙肩韧带和肩袖中更为常见，而帕西尼小体主要见于关节囊。一般来说，球状体神经末梢在喙肩韧带和肩袖中比在前下关节囊中更常见，并且在关节囊前下部内，球状体数量从内侧到外侧增加。致密的韧带组织几乎无神经，而关节周围的脂肪或疏松结缔组织含有神经纤维和神经末梢。鉴于其他实验和临床研究的结果，肩袖和喙肩韧带中鲁菲尼小体和帕西尼小体的高频率表明，两者都参与了肩肱关节稳定性和肩峰下撞击的神经感觉控制。相比之下，我们在关节囊中的发现并不能明确证明，那些关节感受器主要维持关节稳定性。
