Does the glenohumeral joint capsule have proprioceptive capability?
We performed a clinical study examining 60 volunteers with stable shoulder joints randomized to two groups. In group 1 we injected 5 ml lidocaine intra-articularly. In group 2 we injected 5 ml saline with 5 ml contrast dye the same way. After the injection we measured the amount of passive anteroposterior translation that occurred during anterior and posterior drawer tests and the amount of inferior subluxation during downward stress. We documented the extent of the passive glenohumeral translation using ultrasound. We had no complications related to the intra-articular injection or to the stability measurement. After the injection neither group had significant pain, and the patients were not apprehensive about the ensuing stability test. In group 1 (lidocaine) anteroposterior translation of 13.2 +/- 6.3 mm was seen in the anterior and posterior drawer test, whereas in group 2 (no lidocaine) the anteroposterior translation was only 6.8 +/- 3.2 mm. The difference between the two groups was statistically significant (P < 0.05). With downward stress during the sulcus test the distance between the acromion and the humeral head increased by 5.6 mm (+/- 3.2) in group 1 and by 2.7 mm (+/- 2.1) in group 2. This difference was also statistically significant (P < 0.05). Clinical consequences: Taking our preliminary findings into account, the capsule of the glenohumeral joint seems to have proprioceptive capability. Nerve fibres and mechanoreceptors seem to be localized in the capsule tissue, being part of a physiological feedback mechanism. If our conclusions proprioceptive capability. Nerve fibres and mechanoreceptors seem to be localized in the capsule tissue, being part of a physiological feedback mechanism.
Orthopedic Department, Westfälische Wilhelms University, Münster, Germany.
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J
Jerosch
W H
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Castro
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H
Halm
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H
Drescher
D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D017746:Joint Capsule / Q000187:drug effects / Q000294:innervation / Q000502:physiology*; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D011434:Proprioception / Q000187:drug effects / Q000502:physiology; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000294:innervation / Q000502:physiology*; D014463:Ultrasonography
D000779:Anesthetics, Local; D008012:Lidocaine