探讨豆状核、圆韧带和髋关节囊内感觉神经末梢：36 例发育性髋关节发育不良的前瞻性免疫组织化学研究。

Investigation of sensory nerve endings in pulvinar, ligamentum teres, and hip joint capsule: A prospective immunohistochemical study of 36 cases with developmental hip dysplasia.

机构信息

Department of Orthopaedic Surgery, University of Health Sciences Turkey, İstanbul, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.

Department of Pathology, Kahramanmaraş Sütçü İmam University, School of Medicine, Kahramanmaraş, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2021 Jan;55(1):33-37. doi: 10.5152/j.aott.2021.18332.

DOI:10.5152/j.aott.2021.18332

PMID:33650508

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7932737/

Abstract

OBJECTIVE

The aim of this study was to immunohistochemically identify and characterize the presence of sensory nerve endings (SNEs) in pulvinar, ligamentum teres (LT), and hip joint capsule (HJC) of children with developmental dysplasia of the hip (DDH).

METHODS

Pulvinar, LT, and HJC specimens were obtained from 38 hips of 36 children (31 girls, five boys; mean age=49 months; age range=18-132 months) during open reduction surgery for DDH. All specimens underwent subsequent routine tissue processing (formalin fixation and paraffin embedding). To determine tissue morphology, haematoxylin and eosin staining was used. SNEs were analyzed immunohistochemically using a mouse monoclonal antibody against S-100 Beta Protein based on the classification of Freeman and Wyke including four types of SNEs including mechanoreceptors: type I Ruffini corpuscles, type II Pacini corpuscles, type III Golgi organs, and type IVa unmyelinated free nerve endings (FNEs). Additionally, children were sorted into three groups based on their age at the time of surgery: Group 1 (age <3 years; 19 hips of 18), Group 2 (age: 3-5 years; 10 hips of 10 children), and Group 3 (age >5 years; 9 hips of 8 children).

RESULTS

Although no Type I, II, or III SNEs were identified in any specimen, type IVa mechanoreceptor (FNEs) was immunohistochemically characterized in 13 (34%) pulvinar, 19 (50%) LT, and 16 (42%) HJC specimens. The total density of FNEs was 3.31±5.70)/50 mm2 (range 0-21) in pulvinar specimens, 3.18 ± 5.92)/50 mm2 (range 0-24) in HJC specimens, and 4.51±6.61/50 mm2 (range 0-22) in LT specimens. Furthermore, the operated side, gender, and the number of FNEs in specimens did not differ significantly among the age groups (p>0.05 for all), and the number of FNEs was not significantly correlated with age, gender, or the operated side (p>0.05 for all).

CONCLUSION

Evidence from this study revealed that pulvinar, LT, and HJC include only FNEs, which play a role in pain sensation, among mechanoreceptors. Surgical excision of these tissues may not cause a significant loss of sensory function in the hip joint of children with DDH.

LEVEL OF EVIDENCE

Level II, Therapeutic Study.

摘要

目的

本研究旨在通过免疫组织化学方法识别和描述发育性髋关节发育不良（DDH）儿童的豆状核、圆韧带（LT）和髋关节囊（HJC）中感觉神经末梢（SNEs）的存在和特征。

方法

在 DDH 开放复位手术中，从 36 名儿童的 38 髋（31 名女孩，5 名男孩；平均年龄=49 个月；年龄范围=18-132 个月）中获取豆状核、LT 和 HJC 标本。所有标本均进行后续常规组织处理（福尔马林固定和石蜡包埋）。苏木精-伊红染色用于确定组织形态。使用针对 S-100 Beta 蛋白的小鼠单克隆抗体，根据 Freeman 和 Wyke 的分类，对 SNEs 进行免疫组织化学分析，包括四种机械感受器：I 型 Ruffini 小体、II 型 Pacini 小体、III 型高尔基器官和 IVa 型无髓神经末梢（FNEs）。此外，根据手术时的年龄将儿童分为三组：第 1 组（年龄＜3 岁；19 髋，18 名儿童）、第 2 组（年龄：3-5 岁；10 髋，10 名儿童）和第 3 组（年龄＞5 岁；8 髋，8 名儿童）。

结果

尽管在任何标本中均未发现 I 型、II 型或 III 型 SNEs，但在 13 个（34%）豆状核、19 个（50%）LT 和 16 个（42%）HJC 标本中免疫组织化学特征为 IVa 型机械感受器（FNEs）。豆状核标本中 FNEs 的总密度为 3.31±5.70）/50 mm2（范围 0-21），HJC 标本中为 3.18 ± 5.92）/50 mm2（范围 0-24），LT 标本中为 4.51±6.61/50 mm2（范围 0-22）。此外，在年龄组之间，FNEs 的数量在手术侧、性别和标本中没有显著差异（p＞0.05），并且 FNEs 的数量与年龄、性别或手术侧无显著相关性（p＞0.05）。