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Anales de La Real Academia Nacional de... 2008The temporomandibular joint (TMJ) is a complex joint due its development and filogeny. This complexity explains the lack of descriptions of the posterior joint capsule.... (Comparative Study)
Comparative Study Review
The temporomandibular joint (TMJ) is a complex joint due its development and filogeny. This complexity explains the lack of descriptions of the posterior joint capsule. Nowadays it is necessary to establish the limits of this joint part owing to a correct arthroscopic access. Dissecting human cadavers it will determine this joint segment and describe its anatomic relations.
Topics: Adult; Arthroscopy; Cadaver; Dissection; Humans; Imaging, Three-Dimensional; Joint Capsule; Ligaments, Articular; Synovial Membrane; Temporomandibular Joint; Temporomandibular Joint Disc
PubMed: 18777848
DOI: No ID Found -
Matrix Biology : Journal of the... Jul 2000Bovine joint capsule was maintained in explant culture in the presence of bovine aggrecan monomer and it was shown that the aggrecan monomer was degraded. Amino-terminal...
Bovine joint capsule was maintained in explant culture in the presence of bovine aggrecan monomer and it was shown that the aggrecan monomer was degraded. Amino-terminal sequence analysis of the resulting aggrecan core protein fragments revealed that the core protein was cleaved at five specific sites attributed to glutamyl endopeptidases referred to as aggrecanase activity. Fibroblast cultures were established from explant cultures of joint capsule and when these cells were exposed to aggrecan, cleavage of the core protein of aggrecan at the aggrecanase sites was observed. Inclusion of either retinoic acid or interleukin-1alpha in medium of either joint capsule explant cultures or fibroblast cultures did not increase the rate of cleavage of exogenous aggrecan present in the culture medium. When aggrecan monomer was incubated with conditioned medium from explant cultures of joint capsule maintained in medium, degradation could be detected after 10 min. After a 6-h incubation period the same fragments of aggrecan core protein were observed as those for tissue or cells incubated directly with aggrecan monomer. RT-PCR analysis of mRNA extracted from joint capsule fibroblasts showed that these cells express both aggrecanase-1 and -2 [ADAMTS-2 (Tang) and ADAMTS-5].
Topics: Aggrecans; Animals; Cartilage, Articular; Cattle; Culture Media; Culture Media, Conditioned; Culture Techniques; Endopeptidases; Extracellular Matrix Proteins; Fibroblasts; Gene Expression; Joint Capsule; Lectins, C-Type; Metacarpophalangeal Joint; Proteoglycans; Synovial Membrane
PubMed: 10936450
DOI: 10.1016/s0945-053x(00)00069-x -
Journal of Shoulder and Elbow Surgery May 2014The shoulder capsule is the main static stabilizer of the glenohumeral joint. However, few studies specifically address the function of the superior shoulder capsule,...
BACKGROUND
The shoulder capsule is the main static stabilizer of the glenohumeral joint. However, few studies specifically address the function of the superior shoulder capsule, which is usually damaged in patients with complete rotator cuff tears. Therefore, the purpose of this study was to determine the biomechanical contribution of the superior shoulder capsule to passive stability of the glenohumeral joint.
METHODS
Seven cadaveric shoulders were tested with a custom testing system. Glenohumeral translations, subacromial contact pressure, and glenohumeral external and internal rotations were quantified at 5°, 30°, and 60° of glenohumeral abduction. Data were compared among 3 conditions: (1) intact superior capsule, (2) after detaching the superior capsule from the greater tuberosity (tear model), and (3) after complete removal of the superior capsule from the greater tuberosity to the superior glenoid (defect model).
RESULTS
A tear of the superior capsule significantly (P < .05) increased anterior and inferior translations compared with those in the intact capsule. Creation of a superior capsular defect significantly (P < .05) increased glenohumeral translation in all directions, subacromial contact pressure at 30° of glenohumeral abduction, and external and internal rotations compared with those of the intact capsule.
CONCLUSION
The superior shoulder capsule plays an important role in passive stability of the glenohumeral joint. A tear in the superior capsule at the greater tuberosity, which may be seen with partial rotator cuff tears, increased anterior and inferior translations. A defect in the superior capsule, seen in massive cuff tears, increased glenohumeral translations in all directions.
Topics: Aged; Aged, 80 and over; Biomechanical Phenomena; Cadaver; Female; Humans; Joint Capsule; Joint Instability; Male; Range of Motion, Articular; Rotation; Shoulder Joint
PubMed: 24388150
DOI: 10.1016/j.jse.2013.09.025 -
Clinical Anatomy (New York, N.Y.) Oct 2020Based on the currently available literature, total denervation of the elbow joint is considered impossible. However, consensus with respect to the anatomic location of... (Review)
Review
Based on the currently available literature, total denervation of the elbow joint is considered impossible. However, consensus with respect to the anatomic location of sensory branches is lacking. The aim of this literature review was to establish consensus with respect to the anatomic features of the articular branches innervating the elbow joint, as well as the distribution of sensory receptors about its capsule. Four electronic databases were queried, between January 1945 and June 2019. Twenty-one original articles providing a detailed description of the distribution of sensory receptors about the elbow joint capsule (5) and its articular branches (16) were reviewed. The posterior capsule was found to be primarily innervated by the ulnar and radial nerves via combined articular branches and sensory branches of the medial antebrachial cutaneous nerve. The anterior capsule was found to be primarily innervated by a plexus of articular ramifications from muscular branches of mixed nerves (ulnar, musculocutaneous, radial, and median nerves). A higher density of nociceptors and mechano-receptors was identified within the posterior and anterior capsules, respectively. Thorough denervation, via the technique proposed herein, is likely to be sufficient in eliminating pain from degenerative conditions of the elbow joint.
Topics: Elbow Joint; Humans; Joint Capsule; Ligaments, Articular
PubMed: 31883143
DOI: 10.1002/ca.23538 -
Journal of Shoulder and Elbow Surgery Jul 2012To date, there are no studies about the attachment of the articular capsule of the superior shoulder joint. The aim of this study was to measure the width of the...
BACKGROUND
To date, there are no studies about the attachment of the articular capsule of the superior shoulder joint. The aim of this study was to measure the width of the attachment of the articular capsule on the humerus, and to clarify the anatomy and the relationship to the footprint of the rotator cuff.
METHODS
The attachment of the articular capsule on the greater tuberosity was exposed. The width of the attachment of the capsule and the footprint of the rotator cuff were measured.
RESULTS
The maximum capsular width was located at the border between the infraspinatus and the teres minor, and measured 9.1 mm. The minimum capsular width was 3.5 mm, and it was located at 10.9 mm posterior to the anterior margin of the greater tuberosity and 1.5 mm anterior to the posterior margin of the supraspinatus.
CONCLUSION
Prior studies have overestimated the rotator cuff footprint width due to the lack of discrimination between the actual cuff insertion and capsule. The attachment of the articular capsule of the shoulder joint occupied a substantial area of the greater tuberosity. In particular, at the border between the infraspinatus and the teres minor, the very thick attachment of the articular capsule compensated for the lack of attachment of muscular components. The thinnest point of the articular capsule was 11 mm posterior to the anterior margin of the greater tuberosity and very close to the posterior edge of the tapered insertion of the supraspinatus, which could contribute to the etiology of degenerative rotator cuff tears.
Topics: Aged; Cadaver; Female; Humans; Humerus; Joint Capsule; Male; Muscle, Skeletal; Rotator Cuff; Sensitivity and Specificity; Shoulder Joint
PubMed: 21816631
DOI: 10.1016/j.jse.2011.04.034 -
Journal of Shoulder and Elbow Surgery 2009We hypothesized that both the AC joint capsule and CC ligaments are biomechanically robust structures in the anterior-posterior (AP) and superior-inferior (SI) planes...
HYPOTHESIS
We hypothesized that both the AC joint capsule and CC ligaments are biomechanically robust structures in the anterior-posterior (AP) and superior-inferior (SI) planes with low loads, and that these ligaments provide essential function in AC joint stability.
MATERIALS AND METHODS
Anterior-posterior (AP) and superior-inferior (SI) AC joint translations were quantified in 6 cadaver matched pairs with AC joint compressions of 10N, 20N and 30N, and with translational loads of 10N and 15N. Either the AC joint capsule or CC ligaments were transected, and measurements were then repeated. Biomechanical characteristics of the remaining AC joint capsule or CC ligaments were compared.
RESULTS
There were significant increases in AP translation with the cut AC joint capsule, and significant increases in SI translation with the cut CC ligaments (P < 0.0001). Compression significantly decreased translation (P < 0.0001).
DISCUSSION
Our study is supported by, and further develops, recent studies and anatomical knowledge. It offers two interpreted pieces of information for the sports medicine physician to consider for reconstruction of the AC joint. First, resection of the distal clavicle may have a detrimental effect. Second, repair of the AC joint capsule, in addition to the customarily repaired CC ligaments, appears to have a beneficial effect.
CONCLUSION
The AC joint capsule is a robust anatomical structure that contributes significantly to the AC joint stability, especially in the AP plane. Compression increases stability.
LEVEL OF EVIDENCE
Basic science study.
Topics: Acromioclavicular Joint; Aged; Biomechanical Phenomena; Cadaver; Female; Humans; Joint Capsule; Ligaments, Articular; Male; Middle Aged
PubMed: 19111475
DOI: 10.1016/j.jse.2008.08.003 -
Pediatric Rheumatology Online Journal Jan 2017The usefulness of musculoskeletal ultrasonography (MSUS) in paediatric population is limited by lack of reference values. One of such parameters is hip joint capsule...
BACKGROUND
The usefulness of musculoskeletal ultrasonography (MSUS) in paediatric population is limited by lack of reference values. One of such parameters is hip joint capsule thickness, postulated as an early measure for synovitis. However, the joint capsule is hardly a distinguished structure from slit synovial cavity in patients with little or no fluid collection. Therefore, in patients without effusion, it is more convenient to measure hip joint capsule thickness together with synovial cavity. The aim of the study was to establish percentile chart for hip joint capsule and synovial cavity thickness (HJC&SCT) in apparently healthy children.
MATERIAL AND METHODS
The analysis included 816 US of hip joint in 408 children without musculoskeletal disorders, distributed equally throughout the whole developmental period in 18 one-year subgroups. Hip joints US was performed according to standard protocol including measurement of HJC&SCT in a single rheumatology centre by three investigators.
RESULTS
The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th HJC&SCT percentile curves were depicted in the age and height charts for the combined group of girls and boys. The median HJC&SCT values were increasing with age from 3.7 (C10 - C90: 3.3 - 4.2) mm in the first year of life up to 6.7 (5.8 - 7.3) in 16 years old, and above. In a similar way the increase was seen with height from 3.9 (3.5 - 4.7) mm in shorter than 95 cm to 6.9 (6.2 - 7.4) mm in taller than 169 cm subjects. Intra-observer and inter-observer mean precision was less than 1.8 and 12.5%, respectively.
CONCLUSION
The developed centile chart for hip joint capsule and synovial cavity thickness in the paediatric population is expected to improve detection of hip joint capsule disorders, including synovitis in juvenile idiopathic arthritis.
Topics: Adolescent; Child; Child Development; Child, Preschool; Female; Hip Joint; Humans; Joint Capsule; Male; Observer Variation; Reference Values; Regression Analysis; Ultrasonography
PubMed: 28143500
DOI: 10.1186/s12969-017-0136-6 -
Seminars in Musculoskeletal Radiology Jul 2015The glenohumeral joint is an inherently unstable articulation and consequently the most frequently subluxed and frankly dislocated joint in the body. Shoulder... (Review)
Review
The glenohumeral joint is an inherently unstable articulation and consequently the most frequently subluxed and frankly dislocated joint in the body. Shoulder instability can be uni- or multidirectional related to acute or repetitive stress and is occasionally secondary to congenital or developmental abnormalities such as a lax joint capsule or glenoid dysplasia. The clinical diagnosis of instability can be difficult, and knowledge of the imaging findings of anterior, posterior, multidirectional, and microinstability is essential to guide the correct treatment of these patients. This requires the appropriate use of many different imaging modalities as well as specific positioning and directed protocols. This review article explains the clinical scenarios associated with shoulder instability and how they relate to the choice of imaging techniques. The imaging findings of the most common soft tissue and osseous pathology are reviewed and explained with specific attention to anterior and posterior instability.
Topics: Humans; Joint Capsule; Joint Instability; Ligaments, Articular; Magnetic Resonance Imaging; Rotator Cuff; Shoulder Joint
PubMed: 26021586
DOI: 10.1055/s-0035-1549319 -
Spine Apr 2014Nonrandomized controlled cohort.
STUDY DESIGN
Nonrandomized controlled cohort.
OBJECTIVE
To characterize subaxial cervical facet joint kinematics and facet joint capsule (FJC) deformation during in vivo, dynamic flexion-extension. To assess the effect of single-level anterior arthrodesis on adjacent segment FJC deformation.
SUMMARY OF BACKGROUND DATA
The cervical facet joint has been identified as the most common source of neck pain, and it is thought to play a role in chronic neck pain related to whiplash injury. Our current knowledge of cervical facet joint kinematics is based on cadaveric mechanical testing.
METHODS
Fourteen asymptomatic controls and 9 C5-C6 arthrodesis patients performed full range of motion flexion-extension while biplane radiographs were collected at 30 Hz. A volumetric model-based tracking process determined 3-dimensional vertebral position with submillimeter accuracy. FJC fibers were modeled and grouped into anterior, lateral, posterior-lateral, posterior, and posterior-medial regions. FJC fiber deformations (total, shear, and compression-distraction) relative to the static position were determined for each cervical motion segment (C2-C3 through C6-C7) during flexion-extension.
RESULTS
No significant differences in the rate of fiber deformation in flexion were identified among motion segments (P = 0.159); however, significant differences were observed among fiber regions (P < 0.001). Significant differences in the rate of fiber deformation in extension were identified among motion segments (P < 0.001) and among fiber regions (P = 0.001). The rate of FJC deformation in extension adjacent to the arthrodesis was 45% less than that in corresponding motion segments in control subjects (P = 0.001).
CONCLUSION
In control subjects, FJC deformations are significantly different among vertebral levels and capsule regions when vertebrae are in an extended orientation. In a flexed orientation, FJC deformations are different only among capsule regions. Single-level anterior arthrodesis is associated with significantly less FJC deformation adjacent to the arthrodesis when the spine is in an extended orientation.
LEVEL OF EVIDENCE
4.
Topics: Adult; Biomechanical Phenomena; Case-Control Studies; Cervical Vertebrae; Female; Humans; Imaging, Three-Dimensional; Joint Capsule; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Range of Motion, Articular; Spinal Diseases; Spinal Fusion; Tomography, X-Ray Computed; Treatment Outcome; Zygapophyseal Joint
PubMed: 24480943
DOI: 10.1097/BRS.0000000000000235 -
PloS One 2016The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle...
BACKGROUND
The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle strength and shoulder function. To facilitate study of possible biologic mechanisms involved in early degenerative changes to rotator cuff muscle and tendon tissues, the objective of this study was to develop a joint capsule injury model in the canine shoulder using arthroscopy.
METHODS
Arthroscopic surgical methods for performing a posterior joint capsulectomy in the canine shoulder were first defined in cadavers. Subsequently, one canine subject underwent bilateral shoulder joint capsulectomy using arthroscopy, arthroscopic surveillance at 2, 4 and 8 weeks, and gross and histologic examination of the joint at 10 weeks.
RESULTS
The canine subject was weight-bearing within eight hours after index and follow-up surgeries and had no significant soft tissue swelling of the shoulder girdle or gross lameness. Chronic synovitis and macroscopic and microscopic evidence of pathologic changes to the rotator cuff bony insertions, tendons, myotendinous junctions and muscles were observed.
CONCLUSIONS
This study demonstrates feasibility and proof-of-concept for a joint capsule injury model in the canine shoulder. Future work is needed to define the observed pathologic changes and their role in the progression of rotator cuff disease. Ultimately, better understanding of the biologic mechanisms of early progression of rotator cuff disease may lead to clinical interventions to halt or slow this process and avoid the more advanced and often irreversible conditions of large tendon tears with muscle fatty atrophy.
Topics: Animals; Arthroscopy; Disease Models, Animal; Dogs; Female; Joint Capsule; Joint Diseases; Shoulder Joint
PubMed: 26808837
DOI: 10.1371/journal.pone.0147949