Quantitative analysis of neural distribution in human coracoacromial ligaments

This study investigated sensory nerve distribution in 27 human coracoacromial ligaments by immunohistochemical methods using antiprotein gene product 9.5 antibody and anticalcitonin gene related peptide antibody. Mean nerve densities were compared among three areas (acromion side, center, and coracoid side) in two groups (patients with rotator cuff tears and patients with shoulder dislocations). In all three areas of both groups, many nerve fibers immunoreactive to antiprotein gene product 9.5 antibody were observed in the periligamentous bursal tissue. However, in the ligament parenchyma, nerve fibers immunoreactive to antiprotein gene product 9.5 antibody were recognized only around blood vessels. Nerve fibers immunoreactive to anticalcitonin gene related peptide antibody were recognized in the periligamentous bursal tissue. However, in the ligament parenchyma, there were no nerve fibers immunoreactive to anticalcitonin gene related peptide antibody. Nerve density of the rotator cuff tear group, as revealed by both immunostainings, showed a significant increase compared with that of the shoulder dislocation group in all three areas. The results of this study show that it is possible the increase in sensory nociceptive nerve fibers in the coracoacromial ligaments may be one of the causes for pain in patients with rotator cuff tears.