Glenohumeral Joint Translation after Arthroscopic, Nonablative, Thermal Capsuloplasty with a Laser

• Published in: The American journal of sports medicine 1998-07, Vol.26 (4), p.495-498
• Main Authors: Tibone, James E., McMahon, Patrick J., Shrader, Todd A., Sandusky, Matthew D., Lee, Thay Q.
• Format: Article
• Language: English
• Subjects: Aged; Aluminum Silicates; Arthroscopy; Biological and medical sciences; Bones; Cadaver; Diseases of the osteoarticular system. Orthopedic treatment; Endoscopy; Holmium; Humans; Humerus; Humerus - physiology; Hypermobility; Joint Capsule - physiology; Joint Capsule - surgery; Joint instability; Joint Instability - surgery; Joints; Laser Coagulation; Laser surgery; Lasers; Lasers in surgery; Ligaments, Articular - physiology; Ligaments, Articular - surgery; Medical sciences; Middle Aged; Muscular system; Physiological aspects; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of Motion, Articular - physiology; Rotation; Shoulder Joint - physiology; Shoulder Joint - surgery; Sports medicine; Stress, Mechanical; Weight-Bearing; Yttrium
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/03635465980260040301

The purpose of this study was to determine whether there are changes in anterior and posterior glenohumeral translation after arthroscopic, nonablative, thermal capsuloplasty with a laser. Two anteriorly and two posteriorly directed loads were sequentially applied to the humerus of nine cadaveric glenohumeral joints, and anterior and posterior translation of the humerus on the glenoid was measured. The glenoid was rigidly fixed, and the glenohumeral joint was positioned simulating 90° of shoulder abduction and 90° of external rotation. Using the holmium:yttrium-aluminum-garnet laser, thermal energy was then applied to the anterior capsuloligamentous structures and anterior and posterior translation measurements were then repeated. The results showed a significant reduction in anterior and posterior translation after laser anterior capsuloplasty. Anterior translation decreased from 10.9 ± 2.0 mm (mean ± SEM) to 6.4 ± 1.5 mm with the 15-N load; and from 13.4 ± 2.1 mm to 8.9 ± 1.8 mm with the 20-N load. Posterior translation decreased from 7.2 ± 1.2 mm to 4.4 ± 0.6 mm with the 15-N load and from 10.4 ± 1.4 mm to 6.5 ± 0.9 mm with the 20-N load. These results indicate that the holmium:yttrium-aluminum-garnet laser can be used to decrease glenohumeral joint translation and may be an effective treatment for glenohumeral joint instability.