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Function of the glenohumeral ligaments in active stabilisation of the shoulder joint

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The joint capsules and the glenohumeral ligaments of 12 human shoulder specimens were histologically investigated by light microscopy. Serial sections of 15 μm thickness were cut. The tissue was stained following the haematoxylin-eosin and van Giesson techniques. For specific identification of neural elements we made use of a special silver impregnation technique, described by Novotny, for staining axons in peripheral nerves. Axons of different diameters ranging from 0.2 μm to 70 μm were discovered within the ligaments. Close to the humeral site we, found small nerves forming neurovascular bundles. Within their connective tissue sheaths, the axons exhibited a serpentine configuration, which may give extra length and may allow stretching of the nerve during motion. most of the axons discovered were located in the subsynovial layer of the ligaments. In general the diameter of these subsynovial axons did not exceed 10 μm. In addition to these axonal structures, we detected nerve endings which can be classified according to Freeman and Wyke as type II mechanoreceptors (Pacinian corpuscles). These mechanoreceptors had a diameter of approximately 150 μm. They were also positioned directly beneath the synovial membrane and close to the humeral site of insertion of the ligaments.Clinical significance: The described neural structures in the glenohumeral ligaments are of particular clinical importance in the light of the high incidence of recurrent shoulder dislocation and concomitant Bankart lesions. The mechanoreceptors located in the glenohumeral ligaments may control the stabilising shoulder musculature. On this premise, rupture or detachment of these ligaments will lead to a loss of a feedback mechanism.

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Authors and Affiliations

  1. Orthopaedic Department, Institute of Sports Medicine, Westfälische Wilhelms-University Münster, Albert-Schweitzer-Strasse 33, D-48129, Münster, Germany

    J. Jerosch M.D. & J. Steinbeck

  2. Institute of Sports Medicine, Westfälische Wilhelms-University Münster, Münster, Germany

    J. Jerosch M.D.

  3. Institute of Biomechanics, Heinrich-Heine University, Düsseldorf, Düsseldort, Germany

    H. Clahsen & A. Grosse-Hackmann

  4. Institute of Anatomy, Westfälische Wilhelms-University Münster, Münster, Germany

    M. Schmitz-Nahrath

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  1. J. Jerosch M.D.
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  5. A. Grosse-Hackmann
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Jerosch, J., Steinbeck, J., Clahsen, H. et al. Function of the glenohumeral ligaments in active stabilisation of the shoulder joint. Knee Surg, Sports traumatol, Arthroscopy 1, 152–158 (1993). https://doi.org/10.1007/BF01560197

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