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Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, Madison, Wisconsin
Department of Pathology, School of Medicine, University of Wisconsin-Madison, Madison, Wisconsin
Sports, Orthopedic and Rehabilitation Medicine Associates, Menlo Park, California
Presented at the 24th annual meeting of the AOSSM, Vancouver, British Columbia, Canada, July 1998.
|| Address correspondence and reprint requests to Mark D. Markel, DVM, PhD, Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive West, Madison, WI 53706
Glenohumeral joint capsule obtained from 42 patients who had undergone an arthroscopic laser-assisted capsular shift procedure was evaluated histologically. A total of 53 samples from the anterior inferior glenohumeral ligament of the joint capsule were collected before and at various times after the procedure (range, 0 to 38 months). Despite glenohumeral instability, joint capsule of the patients before the procedure showed no significant histologic lesions. Laser treatment significantly altered the histologic properties of the tissue as evidenced by hyalinization of collagen and necrotic cells (time 0). Tissues sampled during the short-term period (3 to 6 months) after the procedure demonstrated fibrous connective tissue with reactive cells and vasculature. Collagen and cell morphology returned to normal in the middle- to long-term period (7 to 38 months) after the procedure, while the number of fibroblasts remained elevated. Joint capsule collected from the shoulders of six patients who experienced stiffness after the procedure showed persistent synovial, cellular, and vascular reaction even after 1 year postoperatively, the cause of which is unclear. This study revealed histologic evidence of robust tissue healing and maturation after thermal treatment by the laser-assisted capsular shift procedure, although mechanical and biochemical characterization of the tissue was not evaluated. Correlation with clinical follow-up must be performed to further clarify the advantages and disadvantages of this procedure.
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