Schulz M M, Lee T Q, Sandusky M D, Tibone J E, McMahon P J
Orthopaedic Biomechanics Laboratory, Veterans Affairs Medical Center, Long Beach, CA 90822, USA.
Arthroscopy. 2001 Apr;17(4):342-7. doi: 10.1053/jars.2001.19677.
The objective of this study was to evaluate the healing response, after thermal treatment with a Ho:YAG laser, on the biomechanical properties of capsular soft tissue.
Before and after trial.
Forty-five New Zealand white rabbits were used in this study. A medial peripatellar retinacular thermal capsuloplasty using a Ho:YAG laser and a lateral peripatellar retinacular release was performed on 1 knee of each rabbit. The contralateral knee served as a control and had a lateral release of the retinaculum only. The temperature of the medial retinaculum was maintained at 55 degrees C +/- 5 degrees C during treatment. The medial peripatellar retinaculum was evaluated at 0, 6, and 12 weeks postoperatively. Tensile testing of the medial retinaculum and a biomechanical assessment evaluating the structural and material properties were performed.
The ultimate load (force) of the medial retinaculum was 70%, 56%, and 84% of control at 0, 6, and 12 weeks, respectively, after the procedure. The stiffness (force/deformation) of the medial retinaculum was 83% of control at 0 weeks, 54% at 6 weeks, and 85% at 12 weeks. The ultimate stress (force/area) of the medial retinaculum also showed a significant reduction at 0 and 6 weeks postoperatively, 63% and 62% of control, respectively. By 12 weeks, the ultimate stress was 83% of control.
Thermal treatment of the medial retinaculum with a Ho:YAG laser results in soft tissue with significantly diminished biomechanical properties after treatment. The results of this study suggest that a 12-week period of minimal stress on the capsular tissues should follow a thermal capsuloplasty procedure.
本研究的目的是评估钬激光热处理后，关节囊软组织生物力学性能的愈合反应。
前后试验。
本研究使用了45只新西兰白兔。对每只兔子的一侧膝关节进行内侧髌周支持带钬激光热囊成形术和外侧髌周支持带松解术。对侧膝关节作为对照，仅进行外侧支持带松解术。治疗期间内侧支持带的温度维持在55摄氏度±5摄氏度。术后0、6和12周对内侧髌周支持带进行评估。对内测支持带进行拉伸试验，并进行评估结构和材料性能的生物力学评估。
术后0、6和12周，内侧支持带的极限负荷（力）分别为对照组的70%、56%和84%。内侧支持带的刚度（力/变形）在0周时为对照组的83%，6周时为54%，12周时为85%。内侧支持带的极限应力（力/面积）在术后0周和6周也显著降低，分别为对照组的63%和62%。到12周时，极限应力为对照组的83%。
用钬激光对内侧支持带进行热处理会导致治疗后软组织的生物力学性能显著降低。本研究结果表明，热囊成形术后应对关节囊组织施加12周的最小应力。
