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Open AccessArticle

Molecular Pattern and Density of Axons in the Long Head of the Biceps Tendon and the Superior Labrum

1
AUVA Trauma Center Vienna Meidling, Kundratstraße 37, 1120 Vienna, Austria
2
Center for Anatomy and Cell Biology, Medical University of Vienna, Währinger Straße 13, 1090 Vienna, Austria
3
Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
4
Faculty of Medicine, Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria
5
Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingen Straße 13, 1200 Vienna, Austria
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(12), 2129; https://doi.org/10.3390/jcm8122129
Received: 19 October 2019 / Revised: 24 November 2019 / Accepted: 26 November 2019 / Published: 3 December 2019
(This article belongs to the Section Orthopedics)
The type II superior labrum anterior to posterior (SLAP) repair is a viable option in young and demanding patients, although a prolonged period of pain after surgery is described in the literature. The reason for this fact remains unknown. Thus, the purpose of this study was to investigate the molecular pattern of the biceps tendon anchor, where the sutures for repair are placed. The long head of the biceps tendon (LHBT), including the superior labrum, was dissected in the setting of reverse total shoulder arthroplasty. Immunohistochemical staining was performed using neurofilament (NF) and protein gene product (PGP) 9.5 as general markers for axons and calcitonin gene-related peptide (CGRP) and substance P for nociceptive transmission. A quantitative assessment was performed according to the two regions of interest (ROIs), i.e., the anterosuperior (ROI I) and the posterosuperior labrum (ROI II). Eleven LHBTs with a mean age of 73 years (range: 66–87 years) were harvested intraoperatively. Six LHBTs were gained in osteoarthrosis and five in fractures. We found an inhomogeneous distribution of axons in the anterosuperior and posterosuperior parts of the labrum in all the specimens irrespective of the age, gender, and baseline situation. There was a significantly higher number (p < 0.01) as well as density (p < 0.001) of NF-positive axons in ROI I compared to ROI II. Nociceptive fibers were always found along the NF-positive axons. Thus, our results indicate that the biceps tendon anchor itself is a highly innervated region comprising different nerve qualities. The anterosuperior labrum contains a higher absolute number and density of axons compared to the posterosuperior parts. Furthermore, we were able to prove the presence of nociceptive fibers in the superior labrum. The results obtained in this study could contribute to the variability of pain after SLAP repair. View Full-Text
Keywords: axons; pain; long head of the biceps tendon; superior labrum; SLAP axons; pain; long head of the biceps tendon; superior labrum; SLAP
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Boesmueller, S.; Blumer, R.; Gesslbauer, B.; Hirtler, L.; Fialka, C.; Mittermayr, R. Molecular Pattern and Density of Axons in the Long Head of the Biceps Tendon and the Superior Labrum. J. Clin. Med. 2019, 8, 2129.

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