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Knee Surgery, Sports Traumatology,... Jan 2018The purpose of the present study was to analyze biopsy samples from the subscapularis tendon and from the joint capsule from male patients with shoulder impingement...
PURPOSE
The purpose of the present study was to analyze biopsy samples from the subscapularis tendon and from the joint capsule from male patients with shoulder impingement syndrome (SAIS) and compare them with samples from male patients with post-traumatic recurrent shoulder instability. The hypothesis of the study was that patients with SAIS would have more histologic and ultrastructural degenerative changes in their subscapularis tendon and joint capsule than patients with post-traumatic recurrent shoulder instability.
METHODS
Male patients scheduled for surgery, with either subacromial decompression or Bankart reconstruction, were included. Four biopsies from each patient were obtained from the capsule and four from the subscapularis tendon during arthroscopic surgery. The histologic characteristics and the presence of glycosaminoglycans were assessed using the light microscope, and the ultrastructure was assessed using a transmission electron microscope.
RESULTS
Eight patients, median age 53 (45-74) years (p < 0.0001), were included in the impingement group, and 12 patients, median age 27 (22-48) years, were included in the instability group. The histologic assessment revealed significantly higher cellularity and total degeneration score in the capsule (p = 0.016 and p = 0.014 respectively) in patients with subacromial impingement compared with the instability patients. The corresponding finding was not made for the subscapularis tendon. The ultrastructural evaluation revealed that the instability patients had more fibrils with a large diameter (indicating less degeneration) in both the subscapularis tendon and the capsule compared with the impingement patients (p < 0.0001).
CONCLUSION
Male patients with subacromial impingement have more histologic and ultrastructural degenerative changes in their shoulder compared with patients with post-traumatic recurrent shoulder instability.
CLINICAL RELEVANCE
It appears that in patients with subacromial impingement, the whole shoulder joint is affected and not only the subacromial space. It is the opinion of the authors that intra-articular therapeutic injections could be tried more often in these patients.
LEVEL OF EVIDENCE
III.
Topics: Adult; Aged; Arthroscopy; Biopsy; Glycosaminoglycans; Humans; Joint Capsule; Joint Instability; Male; Microscopy, Electron, Transmission; Middle Aged; Recurrence; Rotator Cuff; Shoulder; Shoulder Impingement Syndrome; Shoulder Joint; Tendons; Wounds and Injuries; Young Adult
PubMed: 28255657
DOI: 10.1007/s00167-017-4442-9 -
The Journal of Family Practice Mar 2020Palpation of the knee yielded a key diagnostic sign. (Review)
Review
Palpation of the knee yielded a key diagnostic sign.
Topics: Adolescent; Arthralgia; Arthroscopy; Chronic Pain; Conservative Treatment; Disease Progression; Female; Follow-Up Studies; Humans; Joint Capsule; Knee Joint; Magnetic Resonance Imaging; Pain Measurement; Physical Examination; Range of Motion, Articular; Risk Assessment; Severity of Illness Index; Treatment Outcome
PubMed: 32182297
DOI: No ID Found -
Asian Journal of Surgery Nov 2023
Topics: Humans; Giant Cell Tumors; Giant Cell Tumor of Tendon Sheath; Joint Capsule
PubMed: 37328384
DOI: 10.1016/j.asjsur.2023.05.168 -
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Feb 2007In this paper, a three-dimensional finite element analysis (FEA) model was created for bionic artificial joint with joint capsule. Finite element method (FEM) was used...
In this paper, a three-dimensional finite element analysis (FEA) model was created for bionic artificial joint with joint capsule. Finite element method (FEM) was used to calculate and simulate mechanics distribution of the joint capsule under different thickness of the joint capsule, different loading, and different angular displacements. The results of the simulation show that the maximum stress is created in the joint area between artificial joint capsule. And the effect of the thickness of the artificial joint capsule on the stress magnitude and distribution is depend on motion model. On standing situation, the maximum stress decreases with the increase of the thickness of joint capsule. However, on walking situation, the maximum stress increases with the increase of the thickness of joint capsule. Whatever conditions simulated, the maximum stress of the artificial joint capsule is not over the limit of the material strength (9.97 megapascals). All the large stress, which gained from the simulation under different situations, locates at the interface between the capsule and the artificial joint. This is because the artificial joint and the capsule transfer loading each other at the interface. At the same time, supporting area of the capsule at the location of the interface is minimum for the whole vesicle. The stress concentration is inevitable at the interface due to the model structure. This result will offer guidance for the optimum joint structure of the capsule and the artificial joint.
Topics: Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Computer Simulation; Finite Element Analysis; Humans; Imaging, Three-Dimensional; Joint Capsule; Knee Joint; Knee Prosthesis; Models, Biological; Stress, Mechanical
PubMed: 17333904
DOI: No ID Found -
PloS One 2016Contractile myofibroblasts (MFs) accumulate in the joint capsules of patients suffering from posttraumatic joint stiffness. MF activation is controlled by a complex...
BACKGROUND
Contractile myofibroblasts (MFs) accumulate in the joint capsules of patients suffering from posttraumatic joint stiffness. MF activation is controlled by a complex local network of growth factors and cytokines, ending in the increased production of extracellular matrix components followed by soft tissue contracture. Despite the tremendous growth of knowledge in this field, inconsistencies remain in practice and prevention.
METHODS AND FINDINGS
In this in vitro study, we isolated and cultured alpha-smooth muscle actin (α-SMA) positive human joint capsule MFs from biopsy specimens and investigated the effect of profibrotic and antifibrotic agents on MF function. Both TGF-β1 and PDGF significantly induced proliferation and increased extracellular matrix contraction in an established 3D collagen gel contraction model. Furthermore, both growth factors induced α-SMA and collagen type I gene expression in MFs. TGF-β1 down-regulated TGF-β1 and TGF-β receptor (R) 1 and receptor (R) 2 gene expression, while PDGF selectively down-regulated TGF-β receptor 2 gene expression. These effects were blocked by suramin. Interestingly, the anti-oxidant agent superoxide dismutase (SOD) blocked TGF-β1 induced proliferation and collagen gel contraction without modulating the gene expression of α-SMA, collagen type I, TGF-β1, TGF-β R1 and TGF-β R2.
CONCLUSIONS
Our results provide evidence that targeting the TGF-β1 and PDGF pathways in human joint capsule MFs affects their contractile function. TGF-β1 may modulate MF function in the joint capsule not only via the receptor signalling pathway but also by regulating the production of profibrotic reactive oxygen species (ROS). In particular, anti-oxidant agents could offer promising options in developing strategies for the prevention and treatment of posttraumatic joint stiffness in humans.
Topics: Actins; Adult; Aged; Aged, 80 and over; Antibodies; Antineoplastic Agents; Cell Proliferation; Cells, Cultured; Collagen Type I; Female; Humans; Joint Capsule; Male; Middle Aged; Myofibroblasts; Platelet-Derived Growth Factor; Receptors, Transforming Growth Factor beta; Signal Transduction; Superoxide Dismutase; Suramin; Transforming Growth Factor beta1; Up-Regulation; Young Adult
PubMed: 26730954
DOI: 10.1371/journal.pone.0145948 -
Knee Surgery, Sports Traumatology,... Jan 2018A detailed structural anatomy of the posterosuperior shoulder capsule and "glenocapsular ligament" is still rather unknown. The purpose of this study was meticulously to...
PURPOSE
A detailed structural anatomy of the posterosuperior shoulder capsule and "glenocapsular ligament" is still rather unknown. The purpose of this study was meticulously to investigate and describe the structure and blood supply of the glenocapsular ligament on the posterosuperior shoulder joint capsule.
METHOD
Sixteen fixed and twelve fresh cadaveric shoulder specimens with a mean age of 73.4 (±6.4) years were analysed. Dissection without arterial injection was performed on the 16 fixed specimens-using an alcohol-formalin-glycerol solution. Before dissection, the 12 fresh specimens received of arterial injection a 10% aqueous dispersion of latex solution. After the injection, these shoulders were also fixed in an alcohol-formalin-glycerol solution.
RESULTS
The glenocapsular ligament was found in all 28 specimens. Single or double parallel-running bundles of connective tissue fibres were found to form a capsular-ligamentous structure on the posterosuperior part of the joint capsule. One part of the ligament was mediosuperior, another posterosuperior. The mediosuperior part varied in shape, and in 12 of 28 cases, it was absent. The glenocapsular ligament arose from the supraglenoid tubercle and posterior part of the collum scapulae and inserted into the semicircular humeral ligament. The posterior ascending branch of the circumflex scapular artery directly fed small branches laterally and medially to the joint capsule, supplying the glenocapsular ligament and the deep layer of the joint capsule.
CONCLUSION
The glenocapsular ligament is a constant anatomical structure that consists of one or two different parts. The glenocapsular ligament and the posterosuperior part of the joint capsule appear well vascularized via the posterior ascending branch of the circumflex scapular artery.
CLINICAL RELEVANCE
It is the hope of the authors that this anatomical study can help surgeons who perform open or arthroscopic surgery to the posterior part of the shoulder. Knowledge of the vascular anatomy presented in this study may be especially important when incisions are made to the posterior part of the shoulder, and should minimize the risk of complications.
Topics: Aged; Cadaver; Female; Humans; Joint Capsule; Ligaments, Articular; Male; Scapula; Shoulder Joint
PubMed: 28624856
DOI: 10.1007/s00167-017-4603-x -
Journal of Shoulder and Elbow Surgery Jul 2020During anatomic total shoulder arthroplasty (TSA) for primary glenohumeral osteoarthritis (GHOA), the anterior shoulder joint capsule (ASJC) is characterized grossly by...
BACKGROUND
During anatomic total shoulder arthroplasty (TSA) for primary glenohumeral osteoarthritis (GHOA), the anterior shoulder joint capsule (ASJC) is characterized grossly by contracture, synovitis, and fibrosis. In tissues that develop fibrosis, there is substantial cross-talk between macrophages, fibroblasts, and myofibroblasts, modulated by calcium signaling and transient receptor potential (TRP) channel signaling. The purpose of this study was to compare and characterize the degree of synovitis, inflammatory infiltrate, and TRP channel expression in ASJC harvested from shoulders with and without primary GHOA.
METHODS
The ASJC was resected from patients undergoing TSA for primary GHOA or other diagnoses and compared with ASJC from cadaveric donors with no history of shoulder pathology. ASJC was evaluated by immunohistochemistry to characterize synovial lining and capsular inflammatory cell infiltrate and fibrosis, and to evaluate for expression of TRPA1, TRPV1, and TRPV4, known to be involved in fibrosis in other tissues. Blinded sections were evaluated by 3 graders using a semiquantitative scale; then results were compared between diagnosis groups using nonparametric methods.
RESULTS
Compared with normal control, the ASJC in primary GHOA had significantly increased synovitis, fibrosis, mixed inflammatory cell infiltrate including multiple macrophages subsets, and upregulation of TRP channel expression.
CONCLUSION
These data support the clinical findings of ASJC and synovial fibrosis in primary GHOA, identify a mixed inflammatory response, and identify dysregulation of TRP channels in the synovium and joint capsule. Further studies will identify the role of synovial and capsular fibrosis early in the development of GHOA.
Topics: Adult; Arthroplasty, Replacement, Shoulder; Contracture; Female; Fibrosis; Humans; Immunohistochemistry; Joint Capsule; Male; Middle Aged; Osteoarthritis; Shoulder Joint; Synovial Membrane; Transient Receptor Potential Channels; Up-Regulation
PubMed: 32113865
DOI: 10.1016/j.jse.2019.11.013 -
Orthopedics Aug 2004The initial wave of enthusiasm for thermal capsulorrhaphy has subsided. Long-term clinical data were lacking until D'Alessandro et al's prospective study indicated the... (Review)
Review
The initial wave of enthusiasm for thermal capsulorrhaphy has subsided. Long-term clinical data were lacking until D'Alessandro et al's prospective study indicated the results were not as promising as the previously reported short-term studies. Complications including obliteration or attenuation of capsular tissue, axillary nerve injury, and chondrolysis have all been reported in recent years further raising concern about the widespread use of this procedure. The inexact nature of how much "shrinkage" is being performed has led surgeons to further develop surgical technique in capsular plication, shift, or advancement. Although it remains to be seen if these techniques will lead to good clinical outcomes, it appears that they more closely resemble the original operative procedure-anterior capsular shift.
Topics: Axilla; Humans; Hyperthermia, Induced; Joint Capsule; Laser Therapy; Postoperative Care; Postoperative Complications; Recurrence; Shoulder Injuries; Surgical Procedures, Operative; Treatment Outcome
PubMed: 15369001
DOI: 10.3928/0147-7447-20040801-14 -
Journal of Bone and Mineral Metabolism 1999The proliferation and differentiation of cells are greatly influenced by their environment. Many growth factors and cytokines are reported to be environmental factors...
The proliferation and differentiation of cells are greatly influenced by their environment. Many growth factors and cytokines are reported to be environmental factors that affect the proliferation and differentiation of cells. Mechanical stress is also considered to influence these physiological reactions. The joint capsule, which is a part of the joint tissue, plays a very important role in the stability of the joint and in maintaining the intracapsular phenomenon. In patients with dislocated hip arthropathy, this capsule is involved in the weightbearing function by forming a sliding surface between the capsule and the femoral head articular cartilage. The surface of the tissue macroscopically shows cartilaginous change, which indicates cartilaginous differentiation caused by mechanical stress. We examined the cartilage-specific proteoglycan component, which is composed of cartilaginou matrix at the differentiation site. We investigated proteoglycan production, molecular size, and the gene expression of cartilaginous substrate. At the inner layer of the weightbearing area of the joint capsule, proteoglycan production was significantly higher than that of other noncartilaginous tissue. We also identified the gene expression of cartilaginous proteoglycan using the reverse transcription polymerase chain reaction (RT-PCR) method.
Topics: Aggrecans; Biomechanical Phenomena; Cartilage, Articular; Cell Differentiation; Extracellular Matrix Proteins; Female; Gene Expression; Hip Dislocation; Hip Joint; Humans; In Vitro Techniques; Joint Capsule; Lectins, C-Type; Middle Aged; Molecular Weight; Proteoglycans; Reverse Transcriptase Polymerase Chain Reaction; Tissue Distribution
PubMed: 10084395
DOI: 10.1007/s007740050056 -
The Journal of Hand Surgery Jul 2005
Topics: Humans; Joint Capsule; Joint Instability; Postoperative Complications; Pronation; Range of Motion, Articular; Supination; Weight-Bearing; Wrist Injuries; Wrist Joint
PubMed: 16039394
DOI: 10.1016/j.jhsa.2005.03.012