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* Kerlan-Jobe Orthopaedic Clinic, Los Angeles, Irvine, California
Orthopaedic Biomechanics Laboratory, Veterans Affairs Medical Center, Long Beach, and the University of California, Irvine, California
Address correspondence and reprint requests to James E. Tibone, MD, Kerlan-Jobe Orthopaedic Clinic, 6801 Park Terrace, Los Angeles, CA 90045-1539
The purpose of this study was to determine whether there are changes in anterior and posterior glenohumeral translation after arthroscopic, nonablative, thermal capsuloplasty with a laser. Two anteriorly and two posteriorly directed loads were sequentially applied to the humerus of nine cadaveric glenohumeral joints, and anterior and posterior translation of the humerus on the glenoid was measured. The glenoid was rigidly fixed, and the glenohumeral joint was positioned simulating 90° of shoulder abduction and 90° of external rotation. Using the holmium:yttrium-aluminum-garnet laser, thermal energy was then applied to the anterior capsuloligamentous structures and anterior and posterior translation measurements were then repeated. The results showed a significant reduction in anterior and posterior translation after laser anterior capsuloplasty. Anterior translation decreased from 10.9 ± 2.0 mm (mean ± SEM) to 6.4 ± 1.5 mm with the 15-N load; and from 13.4 ± 2.1 mm to 8.9 ± 1.8 mm with the 20-N load. Posterior translation decreased from 7.2 ± 1.2 mm to 4.4 ± 0.6 mm with the 15-N load and from 10.4 ± 1.4 mm to 6.5 ± 0.9 mm with the 20-N load. These results indicate that the holmium:yttrium-aluminum-garnet laser can be used to decrease glenohumeral joint translation and may be an effective treatment for glenohumeral joint instability.
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