Abstract
Objectives The capsuloligamentous structures of the shoulder work as static stabilizers, together
with the biceps and rotator cuff muscles, increasing the contact surface of the glenoid
cavity. Free nerve endings and mechanoreceptors have been identified in the shoulder;
however, there are a few studies that describe the presence of these nerves in the
biceps' insertion. The present study aimed to describe the morphology and distribution
of nerve endings using immunofluorescence with protein gene product 9.5 (PGP 9.5)
and confocal microscopy.
Methods Six labrum-biceps complexes from six fresh-frozen cadavers were studied. The specimens
were coronally cut and prepared using the immunofluorescence technique. In both hematoxylin
and eosin (H&E) and immunofluorescence, the organization of the connective tissue
with parallel collagen fibers was described.
Results In the H&E study, vascular structures and some nerve structures were visualized,
which were identified by the elongated presence of the nerve cell. All specimens analyzed
with immunofluorescence and confocal microscopy demonstrated poor occurrence of morphotypes
of sensory corpuscles and free nerve endings. We identified free nerve endings located
in the labrum and in the bicipital insertion, and sparse nerve endings along the tendon.
Corpuscular endings with fusiform, cuneiform, and oval aspect were identified in the
tendon.
Conclusion These findings support the hypothesis that the generation of pain in the superior
labral tear from Anterior to posterior (SLAP) lesions derives from the more proximal
part of the long biceps cord and even more from the upper labrum. Future quantitative
studies with a larger number of specimens may provide more information on these sensory
systems.
Keywords
biceps - fluorescent antibody technique - labrum - mechanoreceptors - nerve endings
- shoulder
