"" Blood Supply of the Superior Glenohumeral Ligament: A Gross Anatomical and Histological Study

Research Article

Austin J Anat. 2016; 3(1): 1048.

Blood Supply of the Superior Glenohumeral Ligament: A Gross Anatomical and Histological Study

Põldoja E1*, Rahu M2, Kask K2, Bulecza T1, Weyers I3 and Kolts I1

1Department of Anatomy, University of Tartu, Estonia

2Department of Orthopaedics, North Estonia Medical Centre Foundation, Estonia

3Institute of Anatomy, University of Lübeck, Germany

*Corresponding author: Põldoja E, Department of Anatomy, The University of Tartu, Ravila Street 19, Tartu 50411, Estonia

Received: December 27, 2015; Accepted: February 22, 2016; Published: February 26, 2016

Abstract

Background: The purpose of this study was to investigate the blood supply of the superior glenohumeral ligament.The purpose of this study was to investigate the blood supply of the superior glenohumeral ligament.

Method: Thirty two fresh cadaveric shoulder specimens (20M/12F) were used in this study. Arterial injection and dissection were performed in 16 specimens (10M/6F) and in the other 15 specimens (9M/6F) the superior glenohumeral ligament was biopsied to carry out a histological and immunohistochemical analysis. One fixed (1M) specimen was finely dissected to illustrate the glenohumeral joint ligamentous structures.

Results: In the dissection study the superior glenohumeral ligament with the oblique and direct parts was tightly connected with the coracohumeral ligament. In the dissection of injected specimens the superior glenohumeral ligament was found to receive blood supply from the suprascapular, axillary and anterior circumflex humeral arteries in all specimens. A single direct branch of the axillary (so-called “subcoracoid artery”) coursed toward the coracohumeral ligament and bifurcated into two smaller branches that ended in the middle third of the superior glenohumeral ligament. In the histological and immunohistochemical analysis the blood supply of the different thirds of the superior glenohumeral ligament is in correlation with the structural changes from the parallel oriented dense connective with a good vasculature, to fibrocartilage with hypovascular regions of the ligament.

Conclusion: The subcoracoid artery is an important source of blood supply of the rotator interval and the coracohumeral and superior glenohumeral ligaments, in addition to the suprascapular and anterior circumflex arteries.

Keywords: Anatomy; Glenohumeral joint capsule; Rotator interval; Superior glenohumeral ligament; Blood supply; Subcoracoid artery

Introduction

The rotator interval, the area between the anterior border of the supraspinatus tendon superiorly and the superior border of the subscapularis tendon inferiorly, is a surgically important landmark for the repair of subscapularis laxity and supraspinatus tendon tears [1-5]. The coracohumeral and superior glenohumeral ligaments, the anterior joint capsule and the tendon of long head of biceps brachii are encompassed by the rotator interval [2,6-8]. In the literature, hypovascularity of these structures has been suggested to play a key role in the rotator cuff pathology (Table 1) [9-15].