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Immunoreactive nerve fibers were found in the soft tissue of the fossa acetabuli as well as in the subintimal part of the synovial layer in the hip joint capsule of groups 1 and 2. In the capsule of controls the innervation density had a median of 5.7 fibers\/cm<jats:sup>2<\/jats:sup> for CGRP\u2010ir and 3.2 fibers\/cm<jats:sup>2<\/jats:sup> for SP\u2010ir afferents. In the osteoarthritic group, the density significantly increased to a median of 15.6 fibers\/cm<jats:sup>2<\/jats:sup> for CGRP\u2010ir and 8.2 fibers\/cm<jats:sup>2<\/jats:sup> for SP\u2010ir neurons (<jats:italic>p<\/jats:italic> = 0.05). Patients with failed hip arthroplasties completely lacked these neuropeptide containing afferents. Innervation density in the fossa acetabuli of osteoarthritc patients showed a median of 14.1 fibers\/cm<jats:sup>2<\/jats:sup> for CGRP\u2010ir and 5.9 fibers\/cm<jats:sup>2<\/jats:sup> for SP\u2010ir afferents. From these data we assume that the hip joint capsule and the soft tissue of the fossa acetabuli are important triggers of nociception. This is supported by the fact, that patients with loosened total hip arthroplasties, where we failed to detect SP\u2010 and CGRP\u2010immunoreactive fibers, did not feel pain.<\/jats:p><jats:p>The upregulation of SP\u2010 and CGRP\u2010positive neurons in response to arthritic stages suggests a mechanism involving neuropeptides in the maintenance of a painful degenerative joint disease and in mediating noxious stimuli from the periphery. Furthermore, these findings help to explain clinical observations, such as effectiveness of local therapy to control hip pain with intraarticular injection, synovectomy and denervation procedures.<\/jats:p>","DOI":"10.1016\/j.ejpain.2005.12.011","type":"journal-article","created":{"date-parts":[[2006,2,8]],"date-time":"2006-02-08T18:25:23Z","timestamp":1139423123000},"page":"67-67","source":"Crossref","is-referenced-by-count":111,"title":["Localization of SP\u2010 and CGRP\u2010immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties"],"prefix":"10.1002","volume":"11","author":[{"given":"Guido","family":"Saxler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"L\u00f6er","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Skumavc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Pf\u00f6rtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Hanesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.80B1.8138"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1521-4052(199912)30:12<746::AID-MAWE746>3.0.CO;2-3"},{"key":"e_1_2_5_4_1","first-page":"114","volume-title":"Operative Zugangswege in der Orthop\u00e4die und Traumatologie. 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