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At least 127 records · Page 7Linked to original sources
PubMed2000

The mechanism of joint capsule thermal modification in an in-vitro sheep model.

The purpose of this study was to understand the mechanism responsible for joint capsule shrinkage after nonablative laser application in an in-vitro sheep model. Femoropatellar joint capsular tissue specimens harvested from 20 adult sheep were treated with one of three power settings of a holmium:yttrium-aluminum-garnet laser or served as a control. Laser treatment significantly shortened the tissue and decreased tissue stiffness in all three laser groups, whereas failure strength was not altered significantly by laser treatment. Transmission electron microscopic examination showed swollen collagen fibrils and loss of membrane integrity of fibroblasts. A thermometric study revealed nonablative laser energy caused tissue temperature to rise in the range of 64 degrees C to 100 degrees C. Electrophoresis after trypsin digestion of the tissue revealed significant loss of distinct alpha bands of Type I collagen in laser treated samples, whereas alpha bands were present in laser treated tissue without trypsin digestion. The results of this study support the concept that the primary mechanism responsible for the effect of nonablative laser energy is thermal denaturation of collagen in joint capsular tissue associated with unwinding of the triple helical structure of the collagen molecule.

Analysis of Variance↗
PubMedDate not supplied

Metatarsophalangeal joint capsule tears: an analysis by arthrography, a new classification system and surgical management.

Metatarsalgia is a common presenting symptom with an established list of differential diagnoses. The authors present a classification system and surgical treatment algorithm for chronic metatarsophalangeal pain due to metatarsophalangeal joint capsule tear. A series of 58 metatarsophalangeal joints with partial tear diagnosed by arthrogram and treated by surgical repair are reviewed. The authors propose a classification system based on preoperative arthrography and a surgical repair procedure for each type of three distinct patterns. A study was developed and funded to perform postoperative arthrograms on 15 patients who had undergone surgical repair using the procedures presented. The purpose of the study was to validate the utility of the arthrogram in the diagnosis and clarification of the nature of the capsular tear. The authors were also able to demonstrate that the arthrographic findings became normal postoperatively, and that surgical repair of a seemingly innocuous capsule tear relieves pain. Fifty-six patients in the series reported relief of their preoperative symptoms. Postoperative arthrograms in 15 patients demonstrated a normal pattern in 73%, 20% had decreased extravasation, and 7% were unchanged.

Adult↗
PubMed1985

[The morphology of sensory corpuscles in the joint capsule--ultrastructural and histochemical study].

Sensory corpuscles in the cat elbow joint were observed by light and electron microscopy. Two types of corpuscles were identified, i.e. Pacini-type and Ruffini-type corpuscles. Silver impregnation revealed a single straight axon terminal in Pacini-type and highly-ramified fine axons in Ruffini-type corpuscles. Pacini-type corpuscles, 100-200 microns long and 30 microns wide, consisted of dense lamellae of lamellar cells and thick capsule. The lamellar portion contained a centrally-located axon terminal, and was similar in organization to the inner core of the typical Pacini corpuscle. The capsule was the continuation of perineurial sheath. This corpuscle was devoid of outer core structure as seen in a typical Pacini corpuscle. Ruffini-type corpuscles, 50-150 microns long and 25-50 microns wide, had the branched axon terminals with varicosities under the incomplete capsule. Axons, which were surrounded by thin Schwann cell processes, were embedded in the dense layers of collagen fibrils. The interior of the corpuscle was separated into small compartments by cell processes extended from the capsule. The axon varicosities contained numerous mitochondria. These fine structures of the corpuscles were similar to those of Ruffini corpuscles reported so far in other regions. Both Pacini-type and Ruffini-type corpuscles were clearly demonstrated by histochemistry for ChE. Inasmuch as the staining feature of corpuscles was different from each other, the distribution pattern of corpuscles in the joint capsules could be obtained by examining semi-serial sections. Pacini-type corpuscles were mainly found in the synovial layer, while Ruffini-type corpuscles were mainly located in the fibrous layer of the joint capsule. Both types of corpuscles were located near the median nerve on the flexor side of the joint. The reaction products of ChE activity were located in the peri-axonal as well as inter-lamellar spaces of Pacini-type corpuscles, and in the peri-axonal region as well as around Schwann cell processes of Ruffini-type corpuscles. No definite reaction product was found within axon terminals. Some reaction products were also found in the rough endoplasmic reticulum and/or nuclear envelope, suggesting that ChE is synthesized by Schwann cells. The significance of these sensory corpuscles with regard to the deep sensation in the joint capsule was discussed from the point of view of the electro-physiological characteristics of the corpuscles.

Animals↗
PubMed1997

Biomechanics of the hip joint capsule -- a mathematical model and clinical implications.

OBJECTIVE: Our aim was to develop a mathematical model to calculate forces, tension and stretching in the hip joint capsule, under conditions caused by the joint effusion usually accompanying hip disease. DESIGN: A mathematical model was developed, based on experimental data from cadaver studies. BACKGROUND: Intracapsular pressure is important with respect to the degree of painless movement in the hip. Previously, we established the relations between the rotation around the axis of the neck of the femur, joint effusion, intracapsular pressure and joint stability. METHODS: In six cadaver adult hips the joint distraction, the traction force along and the rotation around the axis of the neck of the femur and the intracapsular pressure, were simultaneously monitored as the volume of intracapsularly infused saline was increased. The elasticity-constants included in the extracted formula for the fluid pressure were calculated in a designed computer software based on these experimental data. RESULTS: Presented in Figures 3-12. CONCLUSIONS: In the normal joint there is no increase in intracapsular pressure, nor any tension in the hyperboloid shape capsule within the normal range of rotation around the axis of the neck of the femur. This shape is distorted in a hip with effusion, rotation then resulting in an increased intracapsular pressure and tension in the capsule, with potential risk of ruptures.

Journal Article↗
PubMed1980

Regional nerve block of the temporomandibular joint capsule: a technique for clinical research and differential diagnosis.

In previous studies in which regional anesthesia of the temporomandibular joint capsule was used to examine the role of the joint in mandibular movement and distinguish it from muscle control, the anesthetic techniques used have not been satisfactorily described. The accuracy of the injection technique described in this paper was determined by dissection and radiogrphic examination of fixed and fresh specimens. Using this technique, trial patient studies were made using an anesthetic solution to which a radiopaque medium was added. Radiographic examination of the patients affirmed the location of the injected material, while clinical assessment determined its functional effectiveness. Using the described technique, anesthetic solution was accurately and reproducibly introduced posteriorly and laterally to the temporomandibular joint to achieve anesthesia of the joint.

Humans↗
PubMed2001

Autonomic innervation of tendons, ligaments and joint capsules. A morphologic and quantitative study in the rat.

We analyzed the neuronal occurrence of autonomic transmitters; noradrenaline (NA), neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP), in the Achilles tendon, medial and lateral collateral ligaments and knee joint capsule in the rat--by immunohistochemistry (IHC). In addition, the tissue concentrations of the sympathetic neuropeptide, NPY, and the parasympathetic peptide, VIP, were determined by radioimmunoassay (RIA). IHC demonstrated nerve fibers containing sympathetic vasoconstrictors--NA and NPY--and the parasympathetic vasodilator, VIP, in all tissues. NPY- and NA-positive nerve fibers were predominantly observed in larger blood vessels, whereas, nerve fibers immunoreactive to VIP were found in smaller vessels. In many nerve fibers a co-localization of the transmitters was seen. RIA showed that the concentration of NPY compared to VIP was 15-times higher in ligaments and twice as high in tendons and capsules. The differences noted may reflect a difference in vulnerability to degenerative conditions. In pathological conditions, dysregulation of autonomic transmitters in hypovascularized tissues subjected to repetitive mechanical load may contribute to tissue hypoxia leading to degeneration and rupture of tendons and ligaments.

Achilles Tendon↗
PubMed1994

Innervation of the human temporomandibular joint capsule and disc as revealed by immunohistochemistry for neurospecific markers.

An immunohistochemical investigation for the neurospecific markers S-100 protein and protein gene product 9.5 was carried out on 12 healthy temporomandibular joint discs and capsules that were taken at autopsy from human adults. Large nerve trunks in the joint capsule and posterior disc ligament, as well as small nerve bundles and single nerves in almost all parts of the capsule, were heavily stained by anti-S-100 antiserum. The S-100 immunoreactive chondrocytes were also detected in the disc. Antiprotein gene product 9.5 similarly evidenced nerve fibers in the capsule and posterior disc ligament, and it also labeled a few small nerve bundles and a number of single fibers in the peripheral portions of the disc. No corpuscular or specialized endings were encountered in the specimens. These results give new support to the existence of a rich innervation of the human temporomandibular joint capsule and disc that should be further characterized with regard to type, function, and neuropeptide content.

Adolescent↗
PubMed1992

Histological study of the temporomandibular joint capsule: theory of the articular complex.

The findings of the histological study of the human temporomandibular joint confirm that the cranium and the lower jaw are jointed by two temporomandibular articular complexes (one on the left and another on the right side), each made up, in turn, of two joints--a condylomeniscal condyloarthrosis and a reciprocally fitting meniscotemporal joint. Both these joints are surrounded by short capsular bands which stretch from the condyle to the meniscus and from the latter to the temporal bone and form the true joint capsules. Longer bands which extend from the condyle to the temporal bone may be regarded as reinforcements passing over two articulations.

Humans↗
PubMed1990

Salter's osteotomy for the management of joint capsule.

Capsulotomy in primary Salter's osteotomy shaped by T or + and is difficult to tighten joint capsule. A new technique or L-shaped incision i.e., a L-shaped incision on the right hip and a reversed L-shaped incision on the left is designed to incise and sew the capsule. This technique can make the acetabulum fully exposed, and the capsule can be conveniently tightened with overlapping sutures. When it is combined with modified external fixation, redislocation after operation can be avoided.

Acetabulum↗
PubMedDate not supplied

Comparison of human lumbar facet joint capsule strains during simulated high-velocity, low-amplitude spinal manipulation versus physiological motions.

BACKGROUND CONTEXT: Spinal manipulation (SM) is an effective treatment for low back pain (LBP), and it has been theorized that SM induces a beneficial neurophysiological effect by stimulating mechanically sensitive neurons in the lumbar facet joint capsule (FJC). PURPOSE: The purpose of this study was to determine whether human lumbar FJC strains during simulated SM were different from those that occur during physiological motions. STUDY DESIGN/SETTING: Lumbar FJC strains were measured in human cadaveric spine specimens during physiological motions and simulated SM in a laboratory setting. METHODS: Specimens were tested during displacement-controlled physiological motions of flexion, extension, lateral bending, and axial rotations. SM was simulated using combinations of manipulation site (L3, L4, and L5), impulse speed (5, 20, and 50 mm/s), and pre-torque magnitude (applied at T12 to simulate patient position; 0, 5, 10 Nm). FJC strains and vertebral motions (using six degrees of freedom) were measured during both loading protocols. RESULTS: During SM, the applied loads were within the range measured during SM in vivo. Vertebral translations occurred primarily in the direction of the applied load, and were similar in magnitude regardless of manipulation site. Vertebral rotations and FJC strain magnitudes during SM were within the range that occurred during physiological motions. At a given FJC, manipulations delivered distally induced capsule strains similar in magnitude to those that occurred when the manipulation was applied proximally. CONCLUSIONS: FJC strain magnitudes during SM were within the physiological range, suggesting that SM is biomechanically safe. Successful treatment of patients with LBP using SM may not require precise segmental specificity, because the strain magnitudes at a given FJC during SM do not depend upon manipulation site.

Aged↗
PubMed1992

Resorption of bone by inflammatory cells derived from the joint capsule of hip arthroplasties.

The role of inflammatory cells in aseptic loosening and failure of cemented joint replacements is unclear. Inflammatory cells from the revision joint capsule of four failed hip arthroplasties were examined to determine their nature and resorptive capacity. The capsules contained numerous macrophages and abundant foreign-body macrophage polykaryons, distinguished from osteoclasts by their antigenic phenotype and lack of response to calcitonin. When cultured on cortical bone slices in vitro, both macrophages and macrophage polykaryons produced small resorption pits and were associated with areas of superficial resorption of the bone surface. These results indicate that foreign-body induced macrophages and macrophage polykaryons are capable of a type of low-grade bone resorption which may be of pathogenic significance in the loosening of cemented joint prosthetic components.

Antibodies, Monoclonal↗
PubMed2005

Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain.

There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude. The creep rates of SLF and RLF were also measured during each phase and compared to the creep rate predicted by the moment relaxation rate function of the lumbar spine. Both SLF and RLF resulted in significantly increased intervertebral motion, as well as significantly increased FJC strains at the L3-4 to L5-S1 joint levels. These parameters remained increased after the 20-min recovery. Creep during SLF occurred significantly faster than creep during RLF. The moment relaxation rate function was able to accurately predict the creep rate of the lumbar spine at the single moment tested. The data suggest that SLF and RLF result in immediate and residual laxity of the joint and stretch of the FJC, which could increase the potential for LBP.

Aged↗
PubMed2000

Thermally induced shrinkage of joint capsule.

Thermal shrinkage of collagen currently is being used in orthopaedic surgery to treat ligamentous laxity. Understanding the kinetics of collagen shrinkage is key to revealing the events that take place during application of thermal energy. To elucidate the thermokinetic properties of collagen, punch biopsies of bovine joint capsule were immersed in a heated saline bath at temperatures between 20 degrees and 90 degrees C for periods up to 60 minutes. The resulting tissue thermal shrinkage was measured by the change in the cross-sectional area of the specimens. Only a small amount of shrinkage occurred at temperatures below 63 degrees C, and increasing amounts and rates of shrinkage were seen at temperatures between 63 degrees and 72 degrees C. The denaturation kinetics of bovine knee collagen, which could be described by a first order reaction rate, had an activation energy of 2.3 x 10(5) kJ/mol.

Animals↗
PubMed2004

Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective.

BACKGROUND: The axillary nerve is out of the field of view during shoulder arthroscopy, but certain procedures require manipulation of capsular tissue that can threaten the function or integrity of the nerve. We studied fresh cadavers to identify the course of the axillary nerve in relation to the glenoid rim from an intra-articular perspective and to determine how close the nerve travels in relation to the glenoid rim and the inferior glenohumeral ligament. METHODS: We dissected nine whole-body fresh-tissue shoulder joints and exposed the axillary nerve through a window in the inferior glenohumeral ligament. Then we cut coronal sections through the glenoid fossa of ten unembalmed, frozen shoulder specimens after the axillary nerve had been stained with Evans blue dye. All specimens were studied with the joint secured in the lateral decubitus position used for shoulder arthroscopy. RESULTS: Microsurgical dissection through the inferior glenohumeral ligament from within the joint capsule revealed the axillary nerve as it traversed the quadrangular space. In each dissection, the teres minor branch was the closest to the glenoid rim. The coronal sectioning of the unembalmed shoulder specimens demonstrated that the closest point between the axillary nerve and the glenoid rim was at the 6 o'clock position on the inferior glenoid rim. At this position, the average distance between the axillary nerve and the glenoid rim was 12.4 mm. The axillary nerve lay, throughout its course, at an average of 2.5 mm from the inferior glenohumeral ligament. CONCLUSIONS: We used two novel approaches to map the axillary nerve from an intra-articular perspective. Our analysis of the position of the nerve with use of these methods provides the shoulder arthroscopist with essential information regarding the location, route, and morphology of the nerve as it passes inferior to the glenoid rim and shoulder capsule.

Aged↗