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The innervation of the human acetabular labrum and hip joint: an anatomic study.

Alzaharani A, Bali K, Gudena R, Railton P, Ponjevic D, Matyas JR, Powell JN - BMC Musculoskelet Disord (2014)

Bottom Line: FNEs and NEOs were more frequently seen in the antero-superior and postero-superior zones.Four specimens had abundant vascularity and disorganised architecture of FNEs in the deeper zones of the antero-superior quadrant suggestive of a healed tear.These are more abundant in the antero-superior and postero-superior zones.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopedic Trauma & Lower Extremity Reconstruction, 3134 Hospital Drive N,W, Calgary, Alberta T2N 5A1, Canada. jnpowellemail@yahoo.ca.

ABSTRACT

Background: The aim of the current study was to evaluate the innervation of the acetabular labrum in the various zones and to understand its potential role in nociception and proprioception in hips with labral pathology.

Methods: A total of twenty hip labrums were tagged and excised intraoperatively from patients undergoing a total hip replacement. After preparation, the specimens were cut to a thickness of 10 μm and divided into four quadrants (zones) using a clock face pattern. Neurosensory structure distribution was then evaluated using Hematoxylin and Eosin (H and E), and immunoreactivity to S-100.

Results: All specimens had abundant free nerve endings (FNEs). These were seen predominantly superficially and on the chondral side of the labrum. In addition, predominantly three different types of nerve end organs (NEOs) were identified in all twenty specimens. FNEs and NEOs were more frequently seen in the antero-superior and postero-superior zones. Four specimens had abundant vascularity and disorganised architecture of FNEs in the deeper zones of the antero-superior quadrant suggestive of a healed tear. Myofibroblasts were present in abundance in all the labral specimens and were distributed uniformly throughout all labral zones and depth.

Conclusions: The current study shows that the human acetabular labrum has abundant FNEs and NEOs. These are more abundant in the antero-superior and postero-superior zones. The labrum, by virtue of its neural innervation, can potentially mediate pain as well as proprioception of the hip joint, and be involved in neurosecretion that can influence connective tissue repair.

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Diagrammatic representation of histological zones of labral specimens (Right hip here). Adapted from Gerhardt et al.[12].
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Figure 1: Diagrammatic representation of histological zones of labral specimens (Right hip here). Adapted from Gerhardt et al.[12].

Mentions: After the harvest, all the specimens were tagged by a suture placed at the edge of the antero-inferior segment of the labrum (Figure 1). The specimens were then immediately immersed in normal saline and transported to the lab. These were cut into 5-7 mm blocks from different quadrants of labrum and embedded in Optimum Cutting Temperature (OCT) medium and snap frozen. The specimens were then stored at minus 80°C for at least 24 hours. Cryosections were cut at a thickness of 10 μm on a cryostat (Microm HM500 OM), mounted on glass slides, fixed in cold paraformaldehyde, and stored at minus 20°C. Sections were stained using Hematoxylin and Eosin (H and E). Serial sections were stained by indirect immunoperoxidase using a rabbit polyclonal antibody directed against S-100 protein (Dako Canada Inc.), which is widely expressed by cells of the nervous system. The detection system included biotin-conjugated anti-rabbit IgG, streptavidin-conjugated horseradish peroxidase, and diaminobenzidine as a chromogen. Absence of primary antibody served as a negative control. Slides were examined under the light microscope (Zeiss Axioskop2, 63X, 1.4NA objective) using differential-interference contrast illumination.


The innervation of the human acetabular labrum and hip joint: an anatomic study.

Alzaharani A, Bali K, Gudena R, Railton P, Ponjevic D, Matyas JR, Powell JN - BMC Musculoskelet Disord (2014)

Diagrammatic representation of histological zones of labral specimens (Right hip here). Adapted from Gerhardt et al.[12].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927620&req=5

Figure 1: Diagrammatic representation of histological zones of labral specimens (Right hip here). Adapted from Gerhardt et al.[12].
Mentions: After the harvest, all the specimens were tagged by a suture placed at the edge of the antero-inferior segment of the labrum (Figure 1). The specimens were then immediately immersed in normal saline and transported to the lab. These were cut into 5-7 mm blocks from different quadrants of labrum and embedded in Optimum Cutting Temperature (OCT) medium and snap frozen. The specimens were then stored at minus 80°C for at least 24 hours. Cryosections were cut at a thickness of 10 μm on a cryostat (Microm HM500 OM), mounted on glass slides, fixed in cold paraformaldehyde, and stored at minus 20°C. Sections were stained using Hematoxylin and Eosin (H and E). Serial sections were stained by indirect immunoperoxidase using a rabbit polyclonal antibody directed against S-100 protein (Dako Canada Inc.), which is widely expressed by cells of the nervous system. The detection system included biotin-conjugated anti-rabbit IgG, streptavidin-conjugated horseradish peroxidase, and diaminobenzidine as a chromogen. Absence of primary antibody served as a negative control. Slides were examined under the light microscope (Zeiss Axioskop2, 63X, 1.4NA objective) using differential-interference contrast illumination.

Bottom Line: FNEs and NEOs were more frequently seen in the antero-superior and postero-superior zones.Four specimens had abundant vascularity and disorganised architecture of FNEs in the deeper zones of the antero-superior quadrant suggestive of a healed tear.These are more abundant in the antero-superior and postero-superior zones.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopedic Trauma & Lower Extremity Reconstruction, 3134 Hospital Drive N,W, Calgary, Alberta T2N 5A1, Canada. jnpowellemail@yahoo.ca.

ABSTRACT

Background: The aim of the current study was to evaluate the innervation of the acetabular labrum in the various zones and to understand its potential role in nociception and proprioception in hips with labral pathology.

Methods: A total of twenty hip labrums were tagged and excised intraoperatively from patients undergoing a total hip replacement. After preparation, the specimens were cut to a thickness of 10 μm and divided into four quadrants (zones) using a clock face pattern. Neurosensory structure distribution was then evaluated using Hematoxylin and Eosin (H and E), and immunoreactivity to S-100.

Results: All specimens had abundant free nerve endings (FNEs). These were seen predominantly superficially and on the chondral side of the labrum. In addition, predominantly three different types of nerve end organs (NEOs) were identified in all twenty specimens. FNEs and NEOs were more frequently seen in the antero-superior and postero-superior zones. Four specimens had abundant vascularity and disorganised architecture of FNEs in the deeper zones of the antero-superior quadrant suggestive of a healed tear. Myofibroblasts were present in abundance in all the labral specimens and were distributed uniformly throughout all labral zones and depth.

Conclusions: The current study shows that the human acetabular labrum has abundant FNEs and NEOs. These are more abundant in the antero-superior and postero-superior zones. The labrum, by virtue of its neural innervation, can potentially mediate pain as well as proprioception of the hip joint, and be involved in neurosecretion that can influence connective tissue repair.

Show MeSH
Related in: MedlinePlus