Naseef G S, Foster T E, Trauner K, Solhpour S, Anderson R R, Zarins B
Wellman Laboratory of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Am J Sports Med. 1997 Sep-Oct;25(5):670-4. doi: 10.1177/036354659702500514.
Orthopaedic surgeons have recently adapted the holmium: yttrium-aluminum-garnet (YAG) laser for the shrinkage of capsular tissues for treatment of glenohumeral instability. The molecular mechanism of capsular shrinkage has not been documented to date. This study examined the effects of heating on bovine calf knee capsule and subsequent shrinkage of the capsule. Capsule specimens were placed in a saline bath at temperatures ranging from 55 degrees to 75 degrees C for 1, 3, 5, and 10 minutes. Shrinkage was quantified by digital imaging, and the tissue was examined by light and polarized light microscopy. Tissue contraction was not measurable at or below 57.5 degrees C. At 60 degrees C, tissue shrinkage occurred with corresponding basophilic staining and loss of birefringence in collagen fibers. For specimens heated at 60 degrees C and 62 degrees C, shrinkage directly correlated with duration of thermal exposure. Maximal shrinkage of approximately 50% in length occurred at and above 65 degrees C with thermal exposures of 1 minute or greater. This study demonstrates that thermal shrinkage of bovine knee capsule correlates with denaturation of collagen fibers and depends on both time and temperature. Capsular shrinkage treatments may be performed with any energy source that is capable of well-controlled heating of capsular tissue and does not depend on the special properties of laser light.
钇铝石榴石(YAG)激光来收缩关节囊组织，以治疗盂肱关节不稳。迄今为止，关节囊收缩的分子机制尚未见文献记载。本研究检测了加热对小牛膝关节囊的影响以及随后关节囊的收缩情况。将关节囊标本置于温度范围为55℃至75℃的盐水中1、3、5和10分钟。通过数字成像对收缩情况进行量化，并通过光学显微镜和偏振光显微镜对组织进行检查。在57.5℃及以下温度时无法测量到组织收缩。在60℃时，组织出现收缩，同时胶原纤维出现相应的嗜碱性染色和双折射消失。对于在60℃和62℃加热的标本，收缩与热暴露持续时间直接相关。在65℃及以上温度，热暴露1分钟或更长时间时，长度最大收缩约50%。本研究表明，小牛膝关节囊的热收缩与胶原纤维变性相关，且取决于时间和温度。关节囊收缩治疗可以使用任何能够对关节囊组织进行良好控制加热且不依赖激光特殊性质的能量源来进行。
