Hayashi K, Massa K L, Thabit G, Fanton G S, Dillingham M F, Gilchrist K W, Markel M D
Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison 53706, USA.
Am J Sports Med. 1999 Mar-Apr;27(2):162-7. doi: 10.1177/03635465990270020801.
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.
对42例行关节镜激光辅助关节囊移位手术患者的盂肱关节囊进行组织学评估。在手术前及术后不同时间点（0至38个月），从关节囊的下盂肱前韧带共采集了53份样本。尽管存在盂肱关节不稳，但手术前患者的关节囊未显示出明显的组织学病变。激光治疗显著改变了组织的组织学特性，表现为胶原透明化和细胞坏死（时间0）。术后短期内（3至6个月）采集的组织显示为有反应性细胞和血管的纤维结缔组织。术后中长期（7至38个月）胶原和细胞形态恢复正常，而成纤维细胞数量仍保持升高。从6例术后出现僵硬的患者肩部采集的关节囊即使在术后1年仍显示出持续的滑膜、细胞和血管反应，其原因尚不清楚。本研究揭示了激光辅助关节囊移位手术热治疗后组织有力愈合和成熟的组织学证据，尽管未对组织的力学和生化特性进行评估。必须进行与临床随访的相关性研究，以进一步阐明该手术的优缺点。
