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The Bone & Joint Journal

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The Journal of Bone & Joint Surgery British Volume
Vol. 32-B, Issue 1 | Pages 84 - 92
1 Feb 1950
Kellgren JH Samuel EP

1. Pain and pressure sensibility has been studied in the fibrous articular ligament and synovial membrane of the knee joint in normal human subjects and in patients subjected to arthrotomy under local anaesthesia.

2. The fibrous ligament was found to be a highly sensitive structure, containing many spots which give rise to sensations of pain or pressure when stimulated mechanically or chemically. Synovial membrane was found to be a relatively insensitive structure which only occasionally contains pain-sensitive spots.

3. Histological examination of articular capsule from the knee joints of normal and sympathectomised cats shows that articular ligaments have a rich nerve plexus and a variety of specialised and unspecialised nerve endings, most of which are somatic in origin. Synovial membrane contains a more delicate nerve network and also a variety of nerve endings, the majority of which are autonomic in origin. But a substantial number of somatic nerves enter the synovial membrane, some of which terminate in nerve loops, globular endings or simple unspecialised endings.

4. Histological examination of normal human articular capsule shows that its innervation closely resembles that of the cat, but no sympathectomised human material was examined.

5. The bearing of these findings on the symptomatology of joint disease is discussed briefly.