The Thermal Effect of Monopolar Radiofrequency Energy on the                     Properties of Joint Capsule

Hecht, Paul J.; Hayashi, Kei; Cooley, A J; Lu, Yan; Fanton, Gary S.; Thabit, George; Markel, Mark D.

doi:10.1177/03635465980260061201

Cited by 201 publications

(97 citation statements)

References 26 publications

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“…This was followed by a gradual improvement of the tissue's mechanical properties by 6 weeks postoperatively and a full return of preoperative stiffness at 12 weeks. Similarly, Hecht et al 10 reported a 65% reduction of tissue stiffness at 2 weeks following surgery, and a 20% reduction at 6 weeks postoperatively, with a return to preoperative tissue stiffness at 12 weeks following thermal application in a study using a bovine model. Therefore, passive range of motion is initially performed without stretching, as it is necessary to carefully progress the range of motion during the first 4 to 6 weeks when collagen tissue may be susceptible to stretch-out due to a decrease in tissue stiffness.…”

Section: Discussionmentioning

confidence: 84%

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Reinold

Wilk²,

Hooks³

et al. 2003

J Orthop Sports Phys Ther

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Study Design: Descriptive postoperative follow-up research. Objectives: The purpose of this investigation was to describe the return-to-competition rate and functional outcome of overhead athletes following arthroscopic thermal-assisted capsular shrinkage (TACS).Background: Traditional open procedures to correct instability in overhead athletes, such as capsulolabral repairs and capsular shifts, have produced less-than-favorable results, which have led to the development of TACS. Currently there are no long-term follow-up studies documenting the efficacy of this procedure in groups greater than 31 subjects or for a time period greater than 27 months. Methods and Measures: Two hundred thirty-one consecutive overhead athletes who due to symptoms of hyperlaxity had previously undergone a TACS procedure from 1997 to 1999 were selected for inclusion in the study. During a 1-month period, 130 of these athletes (mean age ± SD, 24 ± 6 years; 113 male, 17 female) were contacted by phone for follow-up at a mean of 29.3 months postoperatively (range, 15.4-46.6 months). Of the 130, 105 participated in baseball (80 pitchers), 14 in softball, 4 in football (quarterbacks), 4 in tennis, and 3 in swimming. Fifty-four (42%) subjects were professional, 49 (38%) collegiate, 16 (12%) high school, and 11 (8%) recreational athletes. One hundred twenty-three of the 130 (95%) underwent 1 or more concomitant procedure(s) at the time of TACS. Most commonly performed were labral debridements (69%), rotator cuff debridements (65%), and superior labral repairs (35%). Subjects who returned to competition were retrospectively evaluated using a modified Athletic Shoulder Outcome Rating Scale to subjectively assess pain, strength and endurance, stability, intensity, and performance. Overall results were based on a 90-point scale with scores of 80 to 90 representing excellent, 60 to 79 good, 40 to 59 fair, and less than 40 poor results. Results: One hundred thirteen out of 130 subjects (87%) returned to competition. Mean (±SD) time from surgery to return to competition was 8.4 ± 4.6 months. Mean outcome score for all subjects was 79/90; 75 (66%) subjects had excellent, 24 (21%) good, 11 (10%) fair, and 3 (3%) poor result. The mean outcome score for males was 80/90 and for females was 70/90.

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Section: Discussionmentioning

confidence: 84%

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Reinold

Wilk²,

Hooks³

et al. 2003

J Orthop Sports Phys Ther

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“…During the second half of our experiment, the expansion of the papillary dermis was due mainly to an increase in intercellular substance and the resident cell population (fibroblasts and histiocytes). In other studies, treatment with radiofrequency has been shown to activate tissue repair, causing the proliferation of fibroblasts, among other regenerative processes [26,27]. In no case did we observe any inflammatory response, unlike Zelickson et al [17] and Shumaker et al [19] who have done for human skin from the abdomen and the skin of pigs with cosmetic implants treated with radiofrequency, respectively.…”

Section: Discussionmentioning

confidence: 51%

The effects of radiofrequency on skin: Experimental study

et al. 2008

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Background and Objective: Radiofrequency represents the most recent skin-rejuvenation treatment. The aim of this study was to study the changes in tissues and cells, as well as in the thickness and structure of the skin of guinea pigs following several sessions of radiofrequency. Materials and Methods: Six sessions (1 session/week) of radiofrequency (Thermafine Lift device, Grupo Solilá ser, S.L., Girona, Spain) were applied to the skin of guinea pigs. Biopsies were taken following each session and 2 months following the last application. The resultant samples were included in paraffin via the usual method, sectioned at 5 mm and stained with Haematoxylin-Eosin, Alcian blue, Toluidine blue, van Gieson's and Verhoeff's stains. These techniques were used in order to observe possible changes in the thickness and structures of the skin: mucopolysaccharides and collagen and elastic fibres. Results: The most relevant changes were found in the papillary dermis which underwent an expansion due to oedema and vascular congestion (first half of the experiment), followed by an increase in cellularity and the accumulation of intercellular substance. An increase in collagen, elastic fibres and mucopolysaccharides was observed. Conclusion: The Thermafine Lift device caused no significant macroscopic or microscopic alterations in the skin of guinea pigs, yet increased both the thickness, as well as the mucopolysaccharide, collagen and elastic-fibre content.

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“…In a rabbit model, Schaefer et al (1997) described a generalized fibroblastic response characterized by a marked increase in cellularity and vascularity 8 weeks postoperatively. Hecht et al (1998) examined monopolar radiofrequency energy effects in a sheep model with postoperative follow-up times of 0, 2, 6 and 12 weeks and found immediate postoperative collagen hyalinization and cell necrosis followed by an active tissue repair beyond the sixth week. Hayashi et al (1999) performed a histological evaluation of the glenohumeral joint capsule after laser-assisted shrinkage in 42 patients with shoulder instability.…”

Section: Discussionmentioning

confidence: 99%

“…Correspondingly, progressive rehabilitation causes increased fibroblast proliferation and collagen synthesis in various animal models of tendon and ligament healing, but intensive proliferation and hypercellularity seem to have adverse effects on the mechanical properties of healing tissue (Woo et al 1982, Frank et al 1991, Kamps et al 1994, Atkinson et al 1999). These results have generated controversy concerning the role of mechanical loading, especially since cell necrosis and subsequent intensive fibroblastic response after RF shrinkage have been reported (Hayashi et al 1999, Hecht et al 1998, Pullin et al 1997, Schaefer et al 1997.…”

mentioning

confidence: 99%

Cellularity and apoptosis after radiofrequency-induced shrinkage of collagenous tissue

et al. 2005

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BackgroundElectrothermally-assisted capsular shrinkage has been gaining increased acceptance in the treatment of shoulder instability. Its indication in ACLdeficient knees has been discussed recently.Methods We examined the influence of immobilization on cell homeostasis of healing collagenous tissue after radiofrequency energy was applied to the patellar tendon in 23 rabbits. The animals were killed immediately after surgery (n = 6) or 3 weeks after surgery (n = 17). 10 rabbits were allowed normal cage activity, whereas the treated hind limb of 7 animals was immobilized for 3 weeks in a cast. Feulgen staining was used to stain the DNA of cell nuclei. Cells undergoing apoptosis were identified by the TUNEL method. Quantitative histological assessment was performed using imaging analysis software.Results Severe cellular damage in RF-treated collagenous tissue was partly induced by the immediate onset of apoptosis. At 3 weeks after surgery, non-immobilized tendon showed increased cellularity and apoptosis, whereas immobilization prevented the increase in cellularity and apoptosis significantly. The calculated ratio of apoptosis was not influenced by any postoperative treatment.Interpretation Diminished cellularity and apoptosis during tissue remodeling, due to immobilization, may protect the shortened collagenous scaffold from stretching and further optimize the clinical outcome after radiofrequency shrinkage. To stabilize the shrunken

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The Thermal Effect of Monopolar Radiofrequency Energy on the Properties of Joint Capsule

Cited by 201 publications

References 26 publications

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

Thermal-Assisted Capsular Shrinkage of the Glenohumeral Joint in Overhead Athletes: A 15- to 47-Month Follow-up

The effects of radiofrequency on skin: Experimental study

Cellularity and apoptosis after radiofrequency-induced shrinkage of collagenous tissue

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