Investigation of sensory nerve endings in pulvinar, ligamentum teres, and hip joint capsule: A prospective immunohistochemical study of 36 cases with developmental hip dysplasia. 2021

Cemil Ertürk, and Sezen Koçarslan, and Halil Büyükdoğan, and Mehmet Akif Altay
Department of Orthopaedic Surgery, University of Health Sciences Turkey, İstanbul, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.

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). CONCLUSIONS 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. METHODS Level II, Therapeutic Study.

UI MeSH Term Description Entries
D007150 Immunohistochemistry Histochemical localization of immunoreactive substances using labeled antibodies as reagents. Immunocytochemistry,Immunogold Techniques,Immunogold-Silver Techniques,Immunohistocytochemistry,Immunolabeling Techniques,Immunogold Technics,Immunogold-Silver Technics,Immunolabeling Technics,Immunogold Silver Technics,Immunogold Silver Techniques,Immunogold Technic,Immunogold Technique,Immunogold-Silver Technic,Immunogold-Silver Technique,Immunolabeling Technic,Immunolabeling Technique,Technic, Immunogold,Technic, Immunogold-Silver,Technic, Immunolabeling,Technics, Immunogold,Technics, Immunogold-Silver,Technics, Immunolabeling,Technique, Immunogold,Technique, Immunogold-Silver,Technique, Immunolabeling,Techniques, Immunogold,Techniques, Immunogold-Silver,Techniques, Immunolabeling
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011984 Sensory Receptor Cells Specialized afferent neurons capable of transducing sensory stimuli into NERVE IMPULSES to be transmitted to the CENTRAL NERVOUS SYSTEM. Sometimes sensory receptors for external stimuli are called exteroceptors; for internal stimuli are called interoceptors and proprioceptors. Nerve Endings, Sensory,Neurons, Sensory,Neuroreceptors,Receptors, Neural,Neural Receptors,Receptors, Sensory,Sensory Neurons,Sensory Receptors,Nerve Ending, Sensory,Neural Receptor,Neuron, Sensory,Neuroreceptor,Receptor Cell, Sensory,Receptor Cells, Sensory,Receptor, Neural,Receptor, Sensory,Sensory Nerve Ending,Sensory Nerve Endings,Sensory Neuron,Sensory Receptor,Sensory Receptor Cell
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069590 Round Ligaments Cord-like fibrous tissue structure that connects two articular extremities of bones, ligaments and /or cartilages. Round Ligament,Chorda Obliqua,Ligamentum Teres,Oblique Cord,Round Ligament of Elbow,Chorda Obliquas,Elbow Round Ligament,Elbow Round Ligaments,Ligament, Round,Ligaments, Round,Ligamentum Tere,Oblique Cords
D000082602 Developmental Dysplasia of the Hip Dislocation of the HIP JOINT from an abnormal FEMORAL HEAD to the ACETABULUM relationship. It is most often due to ligamentous laxity, abnormal positioning of the joint and various other developmental, congenital factors, and method of delivery (e.g., OLIGOHYDRAMNIOS). When dislocation is diagnosed in neonates it is referred to as CONGENITAL HIP DYSPLASIA. Developmental Hip Dislocation,Developmental Hip Dysplasia,Hip Dislocation, Developmental,Developmental Hip Dislocations,Developmental Hip Dysplasias,Dislocation, Developmental Hip,Dysplasia, Developmental Hip,Hip Dysplasia, Developmental

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