Kei Hayashi

The Effect of Thermal Heating on the Length and Histologic Properties of the Glenohumeral Joint Capsule

The purpose of this study was to evaluate the effect of temperature on shrinkage and the histologic properties of gienohumeral joint capsular tissue. Six fresh-frozen cadaveric shoulders were used for this study. Seven joint capsule specimens were taken from different re gions from each glenohumeral joint and assigned to one of seven treatment groups (37°, 55°, 60°, 65°, 70°, 75°, 80°C) using a randomized block design. Speci mens were placed in a tissue bath heated to one of the designated temperatures for 10 minutes. Specimens treated with temperatures at or above 65°C experi enced significant shrinkage compared with those treated with a 37°C bath. The posttreatment lengths in the 70°, 75°, and 80°C groups were significantly less than the pretreatment lengths. Histologic analysis re vealed significant thermal alteration characterized by hyalinization of collagen in the 65°, 70°, 75°, and 80°C groups. This study demonstrated that temperatures at or above 65°C caused significant shrinkage of gleno humeral joint capsular tissue. These results are con sistent with histologic findings, which revealed signifi cant thermal changes of collagen in the 65°, 70°, 75°, and 80°C groups. To verify the validity of laser appli cation for shrinkage of joint capsule, studies designed to compare these findings with the effects of laser energy must be performed.

The Thermal Effect of Monopolar Radiofrequency Energy on the Properties of Joint Capsule An In Vivo Histologic Study Using a Sheep Model

The purpose of this in vivo study was to analyze the short-term tissue response of joint capsule to monopolar radiofrequency energy and to compare the effects of five power settings at 65°C on heat distribution in joint capsule. In 12 mature Hampshire sheep, the medial and lateral aspects of both stifles were treated with monopolar radiofrequency energy under arthroscopic control in a single uniform pass to the synovial surface. The radiofrequency generator power settings were 0, 10, 15, 20, 25, and 30 watts (N 8/group). The electrode tip temperature was 65°C. Histologic analysis at 7 days after surgery revealed thermal damage of capsule at all radiofrequency power settings. The lesions cross-sectional area, depth, vascularity, and inflammation were commensurate with radiofrequency power. Tissue damage was indicated by variable inflammatory cell infiltration, fusion of collagen, pyknosis of fibroblasts, myonecrosis, and vascular thrombosis, whereas synovial hyperplasia, fibroblast proliferation, and rowing of sarcolemmal nuclei demonstrated regenerative processes. This study revealed that radiofrequency power settings and heat loss through lavage solution play a significant role in heat distribution and morphologic alterations in joint capsule after arthroscopic application of monopolar radiofrequency energy.

The effect of radiofrequency energy on the ultrastructure of joint capsular collagen.

This study evaluated the effect of radiofrequency energy on the histological and ultrastructural appearance of joint capsular collagen. Femoropatellar joint capsular specimens from adult sheep were treated with one of three treatment temperatures (45 degrees C, 65 degrees C, and 85 degrees C) with a radiofrequency generator or served as control in a randomized block design. Twenty-four specimens (n = 6) were processed for histological examination as well as ultrastructural analysis using transmission electron microscopy. A computer-based area determination program was used to calculate the area affected in histological samples. Histological changes consisted of thermal tissue damage characterized by collagen fiber fusion and fibroblastic nuclear pyknosis at all application temperatures with clear demarcations between treated and untreated tissue. Mean tissue affected ranged from 50.4% for 85 degrees C to 22.5% for 45 degrees C. There was a strong correlation between treatment temperature and percent area affected (P < .001, R2 = .65). Ultrastructural alterations included a general increase in cross-sectional fibril diameter and loss of fibril size variation with increasing treatment temperature. Longitudinal sections of collagen fibrils showed increased fibril diameter and the loss of cross-striations in the treated groups. Thermally induced ultrastructural collagen fibril alteration is likely the predominant mechanism of tissue shrinkage caused by application of radiofrequency energy.

The effect of nonablative laser energy on joint capsular properties: an in vitro mechanical study using a rabbit model

To evaluate the effect of laser energy at nonablative levels on the mechanical properties of joint capsular tissues, we tested the femoropatellar joint capsules of 12 mature New Zealand White rabbits. Specimens were divided into three treatment groups (5, 10, and 15 watts) and one control group. All specimens were first non- destructively mechanically tested to determine stiffness and viscoelastic properties and then treated with laser energy or served as a control. Shrinkage was recorded and mechanical testing was repeated. The application of laser energy resulted in 9%, 26%, and 38% reduction in capsular tissue length for the 5, 10, and 15 watt groups, respectively. Tissue shrinkage was significantly and strongly correlated with energy density. Laser en ergy caused a significant decrease in tensile stiffness only in the 10 and 15 watt groups. Laser energy did not change the relaxation properties at any energy density. This study demonstrates that significant capsular shrinkage can be achieved with the application of non ablative laser energy without detrimental effects to the viscoelastic properties of the tissue; although at higher energy densities, laser energy did lessen capsular stiffness properties. The results of this study should be interpreted with caution until in vivo studies are performed.

The effect of radiofrequency energy on the length and temperature properties of the glenohumeral joint capsule

The purpose of this in vitro study was to evaluate the effect of radiofrequency energy on the length and temperature properties of the glenohumeral joint capsule in a sheep model. Dissected glenohumeral joint capsules were placed in a 37 degrees C tissue bath and treated with radiofrequency energy at temperature settings of 60 degrees, 65 degrees, 70 degrees, 75 degrees and 80 degrees C. Pretreatment and posttreatment tissue length was measured, and tissue temperature changes were recorded at distances of 0.0, 0.5, 1.0, 1.5 mm away from the probe path. Tissue shrinkage was found to be less than 4% for treatments below 65 degrees C, and increased to 14% for treatments at 80 degrees C. Posttreatment lengths of tissues treated at 65 degrees, 70 degrees, 75 degrees, 80 degrees C were significantly shorter than pretreatment lengths. The maximum tissue temperatures directly below the probe were observed to be 3.7 degrees to 6.7 degrees C lower than the set temperatures. As the distance from the probe was increased, the tissue temperature was found to decrease, reaching a value of less than 45 degrees C at 1.5 mm for all five treatment temperature settings. This study provided basic information on temperature settings, tissue shrinkage, and tissue temperature distribution of radiofrequency treatment.

The effect of nonablative laser energy on the ultrastructure of joint capsular collagen

This study was designed to evaluate the effect of laser energy at nonablative levels on the ultrastructure of joint capsular collagen. The femoropatellar joint capsules of six mature New Zealand white rabbits were harvested immediately after death. Specimens were divided into three treatment groups (5, 10, and 15 watts) and one control group. Laser energy was applied using a holmium: YAG laser. Transmission electron microscopy showed significant ultrastructural alterations in collagenous architecture for all laser treatment groups, with increased fibril cross-sectional diameter for each of the treated groups. The fibrils began to lose their distinct edges and their periodical cross-striations at subsequently higher energy densities. A morphometric analysis showed that each subsequently higher laser energy caused a significant increase in collagen fibril diameter. Ultrastructural alteration of collagen fibril architecture caused by the thermal effect of laser energy is probably the dominant mechanism of laser-induced tissue shrinkage.

Monopolar Radiofrequency Energy Effects on Joint Capsular Tissue: Potential Treatment for Joint Instability An In Vivo Mechanical, Morphological, and Biochemical Study Using an Ovine Model

The purpose of this study was to evaluate the thermal effect of monopolar radiofrequency energy, a potential treatment means for joint instability, on the mechanical, morphologic, and biochemical properties of joint capsular tissue in an in vivo ovine model. The energy was applied arthroscopically to the synovial surface of the femoropatellar joint capsule of 24 sheep. The sheep were sacrificed at 0, 2, 6, and 12 weeks after surgery (6 per group). Monopolar radiofrequency energy initially caused a significant decrease in tissue stiffness and an increase in tissue relaxation properties, followed by gradual improvement in the tissues mechanical properties by 6 weeks after surgery. Microscopic examination illustrated that radiofrequency energy initially caused collagen hyalinization and cell necrosis, followed by active tissue repair. Biochemical analysis revealed that treated collagen was significantly more trypsin-susceptibile than untreated collagen at 0 and 2 weeks after surgery, indicating early collagen denaturation. This study demonstrated that this treatment initially caused a significantly deleterious effect on the mechanical properties of the joint capsule, which was associated with partial denaturation of joint capsular tissue. This was followed by gradual improvement of the mechanical, morphologic, and biochemical properties of the tissue over time.

Modulation of osteogenic differentiation in hMSCs cells by submicron topographically-patterned ridges and grooves

Recent studies have shown that nanoscale and submicron topographic cues modulate a menu of fundamental cell behaviors, and the use of topographic cues is an expanding area of study in tissue engineering. We used topographically-patterned substrates containing anisotropically ordered ridges and grooves to investigate the effects of topographic cues on mesenchymal stem cell morphology, proliferation, and osteogenic differentiation. We found that human mesenchymal stem cells cultured on 1400 or 4000 nm pitches showed greater elongation and alignment relative to 400 nm pitch or planar control. Cells cultured on 400 nm pitch demonstrated significant increases in RUNX2 and BGLAP expression relative to cells cultured on 1400 or 4000 nm pitch or planar control. Four-hundred nanometer pitch enhanced extracellular calcium deposition. Cells cultured in osteoinductive medium revealed combinatory effects of topography and chemical cues on 400 nm pitch as well as up-regulation of expression of ID1, a target of the BMP pathway. Our data demonstrate that a specific size scale of topographic cue promotes osteogenic differentiation with or without osteogenic agents. These data demonstrate that the integration of topographic cues may be useful for the fabrication of orthopedic implants.

Cranial Cruciate Ligament Pathophysiology in Dogs With Cruciate Disease: A Review

Cruciate disease is a common cause of chronic lameness in dogs. Midsubstance rupture of the cranial cruciate ligament (CCL) arises from progressive pathological failure, often under conditions of normal loading in adult dogs with CCL instability. A high risk of rupture is associated with inflammation of the synovium and adaptive or degenerative changes in the cells and matrix of the CCL. In contrast, CCL rupture in puppies is usually associated with traumatic injury and avulsion of the CCL from its sites of attachment.

Proposed Definitions and Criteria for Reporting Time Frame, Outcome, and Complications For Clinical Orthopedic Studies in Veterinary Medicine

Outcome, and Complications For Clinical Orthopedic Studies in Veterinary Medicine James L. Cook, DVM, PhD, Diplomate ACVS, Richard Evans, PhD, Michael G. Conzemius, DVM, PhD, Diplomate ACVS, B. Duncan X. Lascelles, BVSc, PhD, Diplomate ECVS, Diplomate ACVS, C. Wayne McIlwraith, BVSc, PhD, Diplomate ACVS, Antonio Pozzi, DMV, MS, Diplomate ACVS, Peter Clegg, MA, VetMB, PhD, Diplomate ECVS, MRCVS, John Innes, BVSc, PhD, DSAS (Orth), MRCVS, Kurt Schulz, DVM, Diplomate ACVS, John Houlton, MA, VetMB, DVR, DSAO, MRCVS, Diplomate ECVS, Lisa Fortier, DVM, PhD, Diplomate ACVS, Alan R. Cross, DVM, Diplomate ACVS, Kei Hayashi, DVM, PhD, Diplomate ACVS, Amy Kapatkin, DVM, MS, Diplomate ACVS, Dorothy Cimino Brown, DVM, MSCE, Diplomate ACVS, and Allison Stewart, DVM, MS, Diplomate ACVS Comparative Orthopaedic Laboratory, University of Missouri, Columbia, MO, College of Veterinary Medicine, University of Illinois, Urbana, IL, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, Comparative Pain Research Laboratory, North Carolina State University,