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Acta Orthopaedica Scandinavica Oct 1998In order to evaluate the capsular reaction to high intraarticular pressure (IAP) in the knee during arthroscopy, we examined 13 patients admitted for elective surgery...
In order to evaluate the capsular reaction to high intraarticular pressure (IAP) in the knee during arthroscopy, we examined 13 patients admitted for elective surgery with joint infusion to 30, 70, 120 and 170 mmHg IAP (4, 9.3, 16 and 22.7 kPa). The infusion was repeated once, at all IAP levels except 30 mmHg, after 2 min and was recorded for another 2 min. A pressure-time curve was recorded as a combined effect of viscoelastic properties of the capsule and extraarticular fluid absorption. 3 more knee joints were infused directly to 170 mmHg and a pressure-time curve was recorded for 15 min, after which time the joint was reinfused to 170 mmHg in order to estimate the change in joint volume due to absorption or relaxation. In 10 knees, the curves were uniform. At infusion, the pressure curve was almost linear above 70 mmHg. There were no signs of plastic deformation of the joint capsule at pressures below 120 mmHg, while at 170 mmHg there were signs of capsular deformation. At each pressure level, the curve revealed a rapid fall in initial pressure that gradually decreased because of capsular relaxation or fluid absorption. Repeated infusion delayed the fall in pressure, due to increased capsular stiffness. In 3 knees infused directly to 170 mmHg IAP, the slope for the first 2 min of the pressure-time curve did not differ from that found at maximal IAP in knees examined with stepwise increasing pressures. Discontinuity of the capsule, even of puncture size, influenced the pressure/volume correlation considerably. We conclude that at IAP levels of 170 mmHg, there are signs of plastic deformation of the joint capsule. In order to avoid capsular damage, knee arthroscopy should be done at intraarticular pressure levels below 120 mmHg.
Topics: Absorption; Adolescent; Adult; Arthroscopy; Elasticity; Elective Surgical Procedures; Endoscopy; Female; Humans; Infusions, Parenteral; Joint Capsule; Knee Joint; Male; Middle Aged; Monitoring, Intraoperative; Pressure; Tensile Strength; Time Factors; Viscosity
PubMed: 9855229
DOI: 10.3109/17453679808997783 -
Revue de Stomatologie, de Chirurgie... Feb 2014Ganglion cyst of the temporomandibular joint is a rare disease, which may arise from myxoid degeneration of the collagenous tissue of the temporomandibular joint... (Review)
Review
INTRODUCTION
Ganglion cyst of the temporomandibular joint is a rare disease, which may arise from myxoid degeneration of the collagenous tissue of the temporomandibular joint capsule, without epithelial or endothelial lining. We report a case of cystic lesion in a 40-year-old female patient.
OBSERVATION
The patient had a left pre-auricular oval-shaped swelling without any articular symptoms. The pathological analysis after surgical removal allowed diagnosing the lesion as a ganglion cyst of the left temporomandibular joint.
DISCUSSION
We made a literature review and noted that this condition was predominant in female patients. We recommend using MRI for diagnostic purposes and surgery as the best therapeutic alternative.
Topics: Adult; Female; Ganglion Cysts; Humans; Joint Capsule; Temporomandibular Joint Disorders
PubMed: 24412035
DOI: 10.1016/j.revsto.2013.09.004 -
Bulletin (Hospital For Joint Diseases... 1996
Review
Topics: Humans; Injections, Intra-Articular; Joint Capsule; Joint Diseases; Low Back Pain; Pain Measurement; Radiography
PubMed: 8933944
DOI: No ID Found -
Stapp Car Crash Journal Nov 2006Many efforts have been made to understand the mechanism of whiplash injury. Recently, the cervical facet joint capsules have been focused on as a potential site of...
Many efforts have been made to understand the mechanism of whiplash injury. Recently, the cervical facet joint capsules have been focused on as a potential site of injury. An experimental approach has been taken to analyze the vertebral motion and to estimate joint capsule stretch that was thought to be a potential cause of pain. The purpose of this study is to analyze the kinematics of the cervical facet joint using a human FE model in order to better understand the injury mechanism. The Total Human Model for Safety (THUMS) was used to visually analyze the local and global kinematics of the spine. Soft tissues in the neck were newly modeled and introduced into THUMS for estimating the loading level in rear impacts. The model was first validated against human test data in the literature by comparing vertebrae motion as well as head and neck responses. Joint capsule strain was estimated from a maximum principal strain output from the elements representing the capsule tissues. A rear-end collision was then simulated using THUMS and a prototype seat model, assuming a delta-V of 25 km/h. The trajectory of the vertebrae was analyzed in a local coordinate system defined along the joint surface. Strain growth in the joint capsules was explained, as related to contact events between the occupant and the seat. A new seat concept was proposed to help lessen the loading level to the neck soft tissues. The foam material of the seat back was softened, the initial gap behind the head was reduced and the head restraint was stiffened for firm support. The lower seat back frame was also reinforced to withstand the impact severity at the given delta-V. Another rear impact simulation was conducted using the new seat concept model to examine the effectiveness of the new concept. The joint capsule strain was found to be relatively lower with the new seat concept. The study also discusses the influence of seat parameters to the vertebral motion and the resultant strain in the joint capsules. The meaning of the contact timing of the head to the head restraint was examined based on the results in terms of correlation with injury indicators such as NIC and the joint capsule strain.
Topics: Acceleration; Accidents, Traffic; Biomechanical Phenomena; Cervical Vertebrae; Computer Simulation; Elasticity; Finite Element Analysis; Humans; Joint Capsule; Models, Biological; Movement; Physical Stimulation; Risk Assessment; Risk Factors; Stress, Mechanical; Whiplash Injuries
PubMed: 17311176
DOI: 10.4271/2006-22-0020 -
Journal of Shoulder and Elbow Surgery Feb 2013
Topics: Female; Humans; Joint Capsule; Male; Muscle, Skeletal; Rotator Cuff; Shoulder Joint
PubMed: 23352476
DOI: 10.1016/j.jse.2012.10.029 -
Clinics in Sports Medicine Jul 2002The skeletally immature athlete poses unique problems in diagnosis and treatment of injuries to the extensor mechanism of the knee. An accurate and detailed history and... (Review)
Review
The skeletally immature athlete poses unique problems in diagnosis and treatment of injuries to the extensor mechanism of the knee. An accurate and detailed history and physical examination of the knee are essential for making a specific diagnosis and formulating an appropriate treatment plan. This article presents an overview of acute and chronic injuries of the extensor mechanism of the knee that are unique to skeletally immature athletes. The subjects of femoral trochlear dysplasia and medial subluxation of the patella are briefly discussed. The etiopathology, clinical evaluation, and management (non-operative and operative) of sleeve fractures of the patella and avulsion fractures of the tibial tubercle in children and adolescents are discussed. The pathoanatomy, clinical features, and management of synovial plica syndrome, Hoffa's syndrome, Osgood-Schlatter disease, and Sinding-Larsen-Johansson disease are presented.
Topics: Adipose Tissue; Adolescent; Athletic Injuries; Child; Cumulative Trauma Disorders; Fractures, Bone; Humans; Joint Capsule; Knee Injuries; Patella; Patellar Dislocation; Radiography; Tibia
PubMed: 12365238
DOI: 10.1016/s0278-5919(01)00008-4 -
Knee Surgery, Sports Traumatology,... Mar 2002The success of arthroscopic capsular release of the glenohumeral joint depends on complete incision of the inferior capsule. This study determined the distance between...
The success of arthroscopic capsular release of the glenohumeral joint depends on complete incision of the inferior capsule. This study determined the distance between capsule and the axillary nerve in different joint positions. In 14 human shoulder specimens the anterior joint capsule and axillary nerve were dissected, and the anterior joint capsule was incised between the 1 and 5 o'clock positions. The shortest distance between the insertion of the inferior capsule and the axillary nerve was measured at the glenoid and humeral insertions in abduction, adduction, internal, and external rotation. The axillary nerve is surrounded from soft connective tissue and is closer to the humeral than to the glenoidal attachment of the joint capsule. During abduction and external rotation the nerve stays in its position while the glenohumeral capsule tightens, which increases the distance between the two structures. This results in the following distances: to the glenoidal/humeral capsule insertion: in adduction and neutral rotation, 21.2+/-4.2/14.2+/-2.6 mm; in abduction and neutral rotation, 24.0+/-4.9/15.0+/-5.0 mm; in abduction and internal rotation, 21.1+/-6.6/14.6+/-3.7 mm; and in abduction and external rotation, 24.9+/-3.8/16.4+/-4.4 mm. Thus, when performing arthroscopic capsular release the incision of the glenohumeral joint capsule should be undertaken at the glenoidal insertion in the abducted and externally rotated shoulder.
Topics: Aged; Aged, 80 and over; Arthroscopy; Axilla; Bursitis; Female; Humans; Joint Capsule; Male; Middle Aged; Posture; Risk Assessment; Shoulder Joint
PubMed: 11914772
DOI: 10.1007/s00167-001-0270-y -
Clinical Anatomy (New York, N.Y.) Mar 2021The three glenohumeral ligaments (superior, middle, and inferior) are discrete thickenings of the glenohumeral joint capsule and are critical to shoulder stability and... (Review)
Review
The three glenohumeral ligaments (superior, middle, and inferior) are discrete thickenings of the glenohumeral joint capsule and are critical to shoulder stability and function. Injuries to this area are a cause of significant musculoskeletal morbidity. A literature search was performed by a review of PubMed, Google Scholar, and OVID for all relevant articles published up until 2020. This study highlights the anatomy, biomechanical function, and injury patterns of the glenohumeral ligaments, which may be relevant to clinical presentation and diagnosis. A detailed understanding of the normal anatomy and biomechanics is a necessary prerequisite to understanding the injury patterns and clinical presentations of disorders involving the glenohumeral ligaments of the shoulder.
Topics: Biomechanical Phenomena; Humans; Joint Capsule; Ligaments, Articular; Shoulder Injuries; Shoulder Joint
PubMed: 33386636
DOI: 10.1002/ca.23717 -
The Journal of Bone and Joint Surgery.... Aug 2006It has been proposed that cervical facet joint capsules are a major source of whiplash pain. However, there is a paucity of neurophysiologic data to support this...
BACKGROUND
It has been proposed that cervical facet joint capsules are a major source of whiplash pain. However, there is a paucity of neurophysiologic data to support this hypothesis. The purposes of this study were to determine the distribution of A-delta and C-fiber sensory receptors in the facet joint capsule and to test their patterns of response to stretch and related sensory function.
METHODS
Laminectomy from C4 to C7 was performed in seventeen goats, while they were under general anesthesia, to expose the C6 nerve roots. Customized dual bipolar electrodes were used to record neural activity from one of the C6 branches. An 8 or 15-V electrical stimulus was used to provoke receptor activity in nine designated areas on the dorsal part of the C5-C6 facet joint capsule. Receptors were classified on the basis of conduction velocities. The waveform of an identified receptor was set up as a template to determine its neural activity in response to capsular stretch. The characteristics of each single receptor's response to capsular stretch were analyzed to determine its sensory function as a mechanoreceptor or nociceptor.
RESULTS
Two hundred and forty-eight receptors on the dorsal part of the C5-C6 facet joint capsule were evoked by electrical stimulation in the seventeen goats. More C-fiber receptors were found on the dorsolateral aspect of the facet joint capsule, where tendons and muscles were attached. The response to stretch of 120 receptors, from twelve goats, were analyzed to classify them into one of four categories (high-threshold mechanoreceptors, non-saturated low-threshold mechanoreceptors, saturated low-threshold mechanoreceptors, and silent receptors) or as unclassified receptors.
CONCLUSIONS
The existence of receptors in the facet joint capsule indicates that the capsule has pain and proprioceptive sensory functions.
Topics: Animals; Cervical Vertebrae; Electric Stimulation; Goats; Joint Capsule; Mechanoreceptors
PubMed: 16882906
DOI: 10.2106/JBJS.E.00880 -
Chinese Medical Journal Jul 2017
Topics: Adult; Female; Humans; Joint Capsule; Joint Instability; Male; Middle Aged; Range of Motion, Articular; Shoulder Joint
PubMed: 28685729
DOI: 10.4103/0366-6999.209883