Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue:: a neurohistological approach to anterior knee pain syndrome
Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue:: a neurohistological approach to anterior knee pain syndrome
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DOI：
10.1007/s00402-005-0796-4
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发表时间：
2005-11-01
影响因子：
2.3
通讯作者：
Rühmann, O
中科院分区：
文献类型：
--
作者：
Bohnsack, M;Meier, F;Rühmann, O
介绍-本研究的目的是确定髌下脂肪垫和邻近滑膜内的神经的分布和数量，特别是关于伤害性物质-P神经。材料与方法对21例标准全膝关节置换术患者（男4例，女17例，平均年龄69岁）行髌下脂肪垫切除术。将脂肪垫解剖成五个标准化片段，固定在福尔马林中并包埋在石蜡中。免疫组织化学技术，使用抗S-100蛋白和物质P（SP）的抗体来确定和指定的神经。结果在50个观察视野（200倍放大）中，我们发现滑膜中平均有106条S-100神经和25条SP神经（24%），脂肪垫内部平均有27条S-100神经和7条SP神经（26%）。对于两种标记物类型，滑膜中的总神经计数显著（P < 0.001）高于脂肪垫中的总神经计数。S-100神经在脂肪垫中央段和外侧段的数量明显增多（P < 0.05），而SP神经在脂肪垫各段的分布均匀。SP神经与脂肪垫内血管的联系（43%，P < 0.05）明显多于滑膜内血管的联系（28%，P < 0.05）。结论髌下脂肪垫内SP能神经的出现和分布提示其在膝前痛综合征中具有伤害性感受功能和神经组织学作用。这些数据支持髌下脂肪垫的神经源性感染可能导致膝前疼痛综合征的假设。
Introduction The purpose of the study was to determine the distribution and number of nerves inside the infrapatellar fat pad and the adjacent synovium, in particular with regards to nociceptive substance-P nerves. Materials and methods The infrapatellar fat pad of the knee was resected from 21 patients (4 male, 17 female, mean age 69 years) during the course of standard total knee arthroplasty operations performed in our clinic. The fat pad was dissected into five standardized segments, fixed in formalin and embedded in paraffin. Immunohistochemical techniques using antibodies against S-100 protein and substance-P (SP) were employed to determine and specify the nerves. Results Studying all the detectable nerves present in 50 observation fields (200-fold magnification), we found an average of 106 S-100 versus 25 SP nerves (24%) in the synovium and 27 S-100- versus 7 SP nerves (26%) in the interior of the fat pad. The total nerve count was significantly (P < 0.001) higher in the synovium than in the fat pad for both marker types. The number of S-100 nerves was significantly (P < 0.05) higher in the central and lateral segments of the fat pad, while SP nerves were equally distributed throughout all segments of the fat-pad. SP nerves were significantly more frequently associated with blood vessels inside the fat pad (43% 1 P < 0.05) than in the synovial tissue (28%). Conclusion The occurrence and distribution of SP nerves inside the infrapatellar fat pad suggest a nociceptive function and a neurohistological role in anterior knee pain syndrome. The data support the hypothesis that a neurogenous infection of the infrapatellar fat pad could contribute to anterior knee pain syndrome.