Online ArticleSensory innervation of the human shoulder joint: the three bridges to break
Section snippets
Materials and methods
The aim of this study was to collect and review international literature describing the ABs of the shoulder joint, as well as the sensory branches to its capsule, ligaments, and bursae. A literature search was performed using 5 different databases: Ovid Medline, Ovid Embase, Scopus, Web of Science, and Cochrane. Articles from 1945 to 2019 were included, and the search was performed using the Medical Subject Headings and keywords. The search was limited to English language literature. The
Quality of studies
Our electronic search yielded a total of 876 studies. After applying inclusion and exclusion criteria, articles underwent full-text evaluation. A total of 13 articles related to shoulder sensory receptors and 22 related to ABs were included in the review. A summary of the search strategy is outlined in Figure 1.
Sensory receptors
Sensory receptors include mechanoreceptors (Ruffini, Pacinian, and Golgi corpuscles) and nociceptors (free nerves endings). Both types were found in the shoulder joint capsule, its
Discussion
The present literature reviewed summarized all described ABs innervating the shoulder joint. The resulting frequency map of AB and sensory receptors provided an anatomical basis with which to design targeted denervation (Table II, Figs. 2 and 3).
There were several identifiable limitations of the reviewed literature. Providing a complete and detailed description of shoulder innervation has long been a challenge to the anatomist. For this reason, few studies have comprehensively described the
Conclusion
The SSN, LPN, AN, and LSN were found to supply ABs to the shoulder joint. The highest density of nociceptors and mechanoreceptors was identified in SAB and anterior GH capsule/ligaments, respectively. Further studies are needed to assess both the safety and efficacy of selective denervation of the PS, while limiting the loss of proprioceptive function.
Disclaimer
Figure 2, Figure 4 were funded by Arthrex, Inc. (Naples, FL, USA). The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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No institutional review board approval was required for this literature review.