Markel M D, Hayashi K, Thabit G, Thielke R J
Comparative Orthopaedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison 53706, USA.
Orthopade. 1996 Feb;25(1):37-41.
Multidirectional and unidirectional glenohumeral instability constitute an important clinical problem, particularly in the athlete. Numerous methods have been described for treatment of glenohumeral instability, including closed management, open and arthroscopic procedures, but none have achieved universal success. The purpose of this study was to evaluate the effect of laser energy at non-ablative energy densities on the mechanical properties of joint capsular tissues in a rabbit model. Femoropatellar joint capsular tissues from 12 mature New Zealand white rabbits were harvested and divided using a randomized block design into three treatment groups with laser at 5 W, 10 W and 15 W, and one control group. Mechanical testing was performed before and after application of laser energy. The application of laser energy resulted in 9%, 26% and 38% reduction in capsular tissue length for the 5-W, 10-W and 15-W group, respectively. Laser energy caused a significant decrease in tensile stiffness in the 10-W and 15-W groups only (P < 0.05). Laser energy did not change the relaxation properties of capsular tissue at any energy density. The loads required to return specimens to their original length were significantly lower for the 5-W group than for the 10-W and 15-W groups. This study demonstrates that significant capsular shrinkage can be achieved with the application of non-ablative Ho:YAG laser energy without detriment to the relaxation properties of the tissue, although at higher energy densities, laser energy did lessen capsular stiffness properties.
多向性和单向性肩关节不稳是一个重要的临床问题，在运动员中尤为如此。已有多种治疗肩关节不稳的方法被描述，包括闭合治疗、开放手术和关节镜手术，但均未取得普遍成功。本研究的目的是在兔模型中评估非消融能量密度的激光能量对关节囊组织力学性能的影响。从12只成年新西兰白兔获取股髌关节囊组织，采用随机区组设计将其分为三组，分别接受5W、10W和15W激光治疗，以及一个对照组。在施加激光能量前后进行力学测试。施加激光能量后，5W、10W和15W组的关节囊组织长度分别减少了9%、26%和38%。仅在10W和15W组中，激光能量导致拉伸刚度显著降低（P<0.05）。在任何能量密度下，激光能量均未改变关节囊组织的松弛特性。5W组将标本恢复至原始长度所需的负荷显著低于10W和15W组。本研究表明，应用非消融钬激光能量可实现显著的关节囊收缩，且不损害组织的松弛特性，尽管在较高能量密度下，激光能量确实会降低关节囊的刚度特性。
