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Keiichi Akita - One of the best experts on this subject based on the ideXlab platform.
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New insight into the iliofemoral ligament based on the anatomical study of the hip Joint Capsule.
Journal of anatomy, 2019Co-Authors: Masahiro Tsutsumi, Akimoto Nimura, Keiichi AkitaAbstract:The iliofemoral ligament, which plays an important role in hip Joint stability, is formed on the anterosuperior region of the hip Joint Capsule. Although the tendon and deep aponeurosis of the gluteus minimus and iliopsoas are partly connected to the same region of the Capsule, the precise location of the connections between the Joint Capsule and the tendons and deep aponeuroses remains unclear. The locations of the tendinous and aponeurotic connections with the Joint Capsule may clarify whether the iliofemoral ligament can be regarded as the dynamic stabilizer. This study investigated the relationships between the anterosuperior region of the Joint Capsule and the tendon and deep aponeurosis of the gluteus minimus and iliopsoas. Fourteen hips from nine cadavers (five males; four females; mean age at death 76.7 years) were analyzed. Ten hips were macroscopically analyzed, and four were histologically analyzed. During macroscopic analysis, the Joint Capsule was detached from the acetabular margin and the femur, and its local thickness was measured using microcomputed tomography (micro-CT). The gluteus minimus tendon was connected to the Joint Capsule, and the lateral end of this connection was adjoined with the tubercle of the femur at the superolateral end of the intertrochanteric line. The deep aponeurosis of the iliopsoas was also connected to the Joint Capsule, and the inferomedial end of its anterior border corresponded with the inferomedial end of the intertrochanteric line. In the micro-CT analysis, capsular thickening was observed at the base of the connection to the gluteus minimus tendon and at the anterior border of the deep aponeurosis of the iliopsoas. A histological study showed that the gluteus minimus tendon and the deep aponeurosis of the iliopsoas were continuous with the hip Joint Capsule. Based on the morphology of the tendinous and aponeurotic connections, local capsular thickening and histological continuity, the transverse and descending parts of the iliofemoral ligament were the Joint Capsules, with fibers arranged according to the connection with the gluteus minimus tendon and the deep aponeurosis of the iliopsoas, respectively. Therefore, the so-called iliofemoral ligament could be regarded as the dynamic stabilizer, with the ability to transmit the muscular power to the Joint via the capsular complex. This anatomical knowledge provides a better understanding of the hip stabilization mechanism.
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Anatomic study of the medial side of the ankle base on the Joint Capsule: an alternative description of the deltoid and spring ligament
Journal of Experimental Orthopaedics, 2019Co-Authors: Kentaro Amaha, Akimoto Nimura, Atsushi Tasaki, Reiko Yamaguchi, Natnicha Kampan, Kumiko Yamaguchi, Ryuichi Kato, Keiichi AkitaAbstract:Background Adult acquired flatfoot deformity (AAFD) is caused by impaired medial ligamentous structures and posterior tibialis tendon dysfunction (PTTD). Although degeneration and trauma could separately cause AAFD, how these factors interact in the pathomechanism of AAFD is unclear. The Joint Capsule in the medial ankle is considered an important structure, providing passive stability by limiting Joint movement. Previous reports on the Joint Capsule suggest its involvement in pathological changes of the ankle, but because of the high priority placed on the ligaments, few reports address the ankle Joint from the Joint Capsule standpoint. The current study aimed to anatomically examine the medial ankle Joint, focusing on the deltoid and spring ligaments in perspective of the Joint Capsule. Methods We conducted a descriptive anatomical study of 19 embalmed cadavers (mean 82.7 years, range 58 to 99). We included 22 embalmed cadaveric ankles. We detached the Joint Capsule in 16 ankles from the anterior to posteromedial Joint, analyzed the capsular attachments of the ankle and adjacent Joints, and measured the widths of the bony attachments. We histologically analyzed the Joint Capsule using Masson’s trichrome staining in 6 ankles. Results The Capsule could be separated as a continuous sheet, including 3 different tissues. The anterior Capsule was composed of fatty tissue. Between the medial malleolus and talus, the Capsule was strongly connected and was composed of fibrous tissue, normally referred to as the deep deltoid ligament. The tibial attachment formed a steric groove, and the talar side of the attachment formed an elliptical depressed area. On the medial part of the subtalar and talonavicular Joints, the Capsule covered the Joints as cartilaginous tissue, normally referred to as the superomedial ligament of the spring ligament. The outer side of the cartilaginous and fibrous tissue formed the sheath floor of the posterior tibialis tendon. Histological analysis revealed three different tissue types. Conclusions The Capsules of the ankle, subtalar, and talonavicular Joints could be detached as a continuous sheet. The deltoid and the superomedial ligament of the spring ligaments could be interpreted as a part of the continuous Capsule, which had different histological features. Level of evidence Descriptive Laboratory Study.
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Anatomic study of the medial side of the ankle base on the Joint Capsule: an alternative description of the deltoid and spring ligament
Journal of experimental orthopaedics, 2019Co-Authors: Kentaro Amaha, Akimoto Nimura, Atsushi Tasaki, Reiko Yamaguchi, Natnicha Kampan, Kumiko Yamaguchi, Ryuichi Kato, Keiichi AkitaAbstract:Adult acquired flatfoot deformity (AAFD) is caused by impaired medial ligamentous structures and posterior tibialis tendon dysfunction (PTTD). Although degeneration and trauma could separately cause AAFD, how these factors interact in the pathomechanism of AAFD is unclear. The Joint Capsule in the medial ankle is considered an important structure, providing passive stability by limiting Joint movement. Previous reports on the Joint Capsule suggest its involvement in pathological changes of the ankle, but because of the high priority placed on the ligaments, few reports address the ankle Joint from the Joint Capsule standpoint. The current study aimed to anatomically examine the medial ankle Joint, focusing on the deltoid and spring ligaments in perspective of the Joint Capsule. We conducted a descriptive anatomical study of 19 embalmed cadavers (mean 82.7 years, range 58 to 99). We included 22 embalmed cadaveric ankles. We detached the Joint Capsule in 16 ankles from the anterior to posteromedial Joint, analyzed the capsular attachments of the ankle and adjacent Joints, and measured the widths of the bony attachments. We histologically analyzed the Joint Capsule using Masson’s trichrome staining in 6 ankles. The Capsule could be separated as a continuous sheet, including 3 different tissues. The anterior Capsule was composed of fatty tissue. Between the medial malleolus and talus, the Capsule was strongly connected and was composed of fibrous tissue, normally referred to as the deep deltoid ligament. The tibial attachment formed a steric groove, and the talar side of the attachment formed an elliptical depressed area. On the medial part of the subtalar and talonavicular Joints, the Capsule covered the Joints as cartilaginous tissue, normally referred to as the superomedial ligament of the spring ligament. The outer side of the cartilaginous and fibrous tissue formed the sheath floor of the posterior tibialis tendon. Histological analysis revealed three different tissue types. The Capsules of the ankle, subtalar, and talonavicular Joints could be detached as a continuous sheet. The deltoid and the superomedial ligament of the spring ligaments could be interpreted as a part of the continuous Capsule, which had different histological features. Descriptive Laboratory Study.
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An anatomic study on the attachment of the Joint Capsule to the tibia in the lateral side of the knee
Surgical and Radiologic Anatomy, 2018Co-Authors: Hisayo Nasu, Akimoto Nimura, Hitomi Fujishiro, Sara Sugiura, Hideyuki Koga, Keiichi AkitaAbstract:Purpose The purpose of the current study was to examine the width, area, and histological characteristics of the capsular attachment to the tibia in the lateral side of the knee. Methods A total of 27 knees were used in this study. The Joint Capsule of the knee was peeled away from the tibia and the width of the capsular attachment to the tibia was measured by two independent observers using a caliper. Interclass correlation coefficients for each value were calculated to evaluate the validity of the measurement. The capsular attachment to the tibia of the seven knees was histologically analyzed using Masson’s trichrome staining. Results At the posterior border of Gerdy’s tubercle, the capsular attachment was wide; the average width was 8.6 mm (SD 3.0). Toward the posterolateral aspect of the knee, the capsular attachment gradually tapered. Finally, the capsular attachment was linear at the apex of the head of the fibula. Histological analysis at the posterior border of Gerdy’s tubercle revealed developed uncalcified fibrocartilage on the capsular attachment. In contrast, at the apex of the head of the fibula, the Joint Capsule was adhered to the Capsule of the proximal tibiofibular Joint. Fibrous connective tissue was directly attached to the calcified fibrocartilage. Conclusions The attachment width of the knee Joint Capsule at the lateral side varied according to location. We consider that this finding on the capsular attachment will facilitate an understanding of the pathology or mechanism of diseases on the lateral side of the knee Joint.
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Joint Capsule attachment to the coronoid process of the ulna: an anatomic study with implications regarding the type 1 fractures of the coronoid process of the O'Driscoll classification
Journal of shoulder and elbow surgery, 2016Co-Authors: Haruhiko Shimura, Akimoto Nimura, Hisayo Nasu, Hitomi Fujishiro, Junya Imatani, Atsushi Okawa, Keiichi AkitaAbstract:Background The attachment of the anterior Joint Capsule on the ulnar coronoid process is not yet completely understood. The purpose of this study was to clarify the anatomic relationship between the anterior Capsule of the elbow Joint and the tip of the coronoid process. Methods Seventeen embalmed elbows were used for this anatomic study. The anterior Capsule of the elbow Joint was reflected, and the attachment of the Capsule on the coronoid process was exposed. The attachment of the Joint Capsule on the coronoid process was macroscopically and histologically observed, its relationship to the coronoid tip was assessed, and the length of the attachment of the Joint Capsule was measured. Results The length of the Capsule attachment at the radial side of the coronoid (11.9 mm) was greater than that at the ulnar side (6.1 mm). The bone thickness on the coronoid tip from the proximal edge of the Joint Capsule attachment was 1.9 mm; together, the cartilage and bone thickness was 4.7 mm. At the radial side of the coronoid, the thickness of the Joint Capsule at the proximal aspect of the attachment of 2 samples was 0.6 mm and 0.3 mm, and that at the tip of the coronoid was 2.6 mm and 1.7 mm, respectively. Conclusions The anterior Capsule of the elbow Joint had a substantial attachment on the radial side of the coronoid process. The subtype 2 tip fractures of the O'Driscoll classification included the Joint Capsule attachment, Joint cartilage, and subchondral bone.
Kevin A. Hildebrand - One of the best experts on this subject based on the ideXlab platform.
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THE EFFECT OF SUBSTANCE P ON Joint Capsule CELL FUNCTION IN COLLAGEN GEL ASSAYS
2012Co-Authors: Kevin A. Hildebrand, Mei Zhang, Paul T. Salo, David A. HartAbstract:Purpose Recent work has shown that Joint contracture severity can be decreased with the mast cell stabilizer ketotifen in association with decreased numbers of myofibroblasts and mast cells in the Joint Capsule of a rabbit model of post-traumatic contractures. Neuropeptides such as Substance P (SP) can induce mast cells to release growth factors. Using a gel contraction assay, we test the hypothesis that Joint Capsule cell-mediated contraction of a collagen gel can be enhanced with SP, but the effect is magnified in the presence of mast cells. Method Anterior elbow Joint Capsules were obtained at the time of surgical release from 2 men (age 34 and 54) and 1 woman (age 40) with chronic (> 1 year) post-traumatic Joint contractures. The human mast cell line HMC-1 (Mayo Clinic, Rochester), SP and the NK1 receptor antagonist RP67580 (Sigma, Oakville, ON) were used. NK1 is the SP receptor. Neutralized Collagen solution composed with 58% Vitrogen 100 purified collagen mixed with HMC-1 cells only (7.5 105), human Capsule cells (2.5 105), or human Capsule cells (2.5 105) and 7.5 105 mast cells (1:3) were cast into 24- well tissue culture plates. In some experiments, SP (1 × 10 −5 M) +/− RP67580 (0.5 mM) were added. The gels were maintained with 0.5 ml DMEM composed with 2% BSA and incubated at 37C for 12 h for gelation to occur. The gels were then detached from the wall and the bottom of culture plate wells, and photographed at regular intervals up to 72 hours. Gel contraction studies were carried out on passage 4 and done in triplicate for each patient. The average value of each patients triplicate was combined to give a mean contraction at each time point. Statistical analysis involved an ANOVA with posthoc Bonferroni correction. P Results Mast cells alone or with SP were unable to contract collagen gels. Joint Capsule cells were able to contract the collagen gels and this was enhanced in the presence of SP, although not statistically significant. Joint Capsule cells combined with mast cells enhanced the gel contraction more than Joint Capsule cells alone or with SP (p Conclusion The in vitro experiment shows that Joint Capsule cell function, in the form of collagen gel contraction, is modified by the presence of mast cells and neuropeptides. These findings are significant as they strengthen the hypothesis that a myofibroblast mast cell neuropeptide fibrosis axis may be contributing to the Joint Capsule changes underling the loss of motion in post-traumatic Joint contractures. In vivo studies with the rabbit model of post-traumatic contractures will be performed using the compounds examined in the current study.
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The mast cell stabilizer ketotifen reduces Joint Capsule fibrosis in a rabbit model of post-traumatic Joint contractures
Inflammation Research, 2012Co-Authors: Michael J. Monument, Mei Zhang, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Objectives Using a rabbit model of post-traumatic Joint contractures, we investigated whether treatment with a mast cell stabilizer after Joint injury would lessen the molecular manifestations of Joint Capsule fibrosis. Methods Surgical Joint injury was used to create stable post-traumatic contractures of the knee in skeletally mature New Zealand white rabbits. Four groups of animals were studied: a non-operated control group ( n = 8), an operated contracture group ( n = 13) and two operated groups treated with the mast cell stabilizer, ketotifen, at doses of 0.5 mg/kg ( n = 9) and 1.0 mg/kg ( n = 9) twice daily. Joint Capsule fibrosis was assessed by quantifying the mRNA and protein levels of α-SMA, tryptase, TGF-β1, collagen I and collagen III. Significance was tested using an ANOVA analysis of variance. Results The protein and mRNA levels of α-SMA, TGF-β1, tryptase and collagen I and III were significantly elevated in the operated contracture group compared to control ( p
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The mast cell stabilizer ketotifen reduces Joint Capsule fibrosis in a rabbit model of post-traumatic Joint contractures
Inflammation Research, 2011Co-Authors: Michael J. Monument, Mei Zhang, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Objectives Using a rabbit model of post-traumatic Joint contractures, we investigated whether treatment with a mast cell stabilizer after Joint injury would lessen the molecular manifestations of Joint Capsule fibrosis.
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3. THE MAST CELL STABILIZER KETOTIFEN, SIGNIFICANTLY REDUCES CONTRACTURE SEVERITY AND MOLECULAR MANIFESTATIONS OF Joint Capsule FIBROSIS IN A RABBIT MODEL OF POSTTRAUMATIC Joint CONTRACTURES
2011Co-Authors: Michael J. Monument, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Purpose: To determine if mast cell activity is vital to the induction of Joint Capsule fibrosis and contracture formation in a rabbit model of posttraumatic Joint contracture. Method: To reproducibly induce Joint contractures, we used a model of surgical injury and immobilization of the knee in skeletally mature New Zealand white rabbits. Four animals groups were studied: a non-operative control group (CON), an operative contracture group (ORC) and two-operative groups treated with a mast cell stabilizer, Ketotifen fumarate at doses of 0.5mg/kg (KF0.5) and 1.0mg/kg (KF1.0) twice daily subcutaneously, respectively. Animals were sacrificed after 8 weeks of immobilization. Flexion contractures (biomechanics), cellular counts of myofibroblasts and mast cells within the Joint Capsule (immunohistochemistry) and the Joint Capsule protein expression of TGF-β1, collagen I and III were quantified (western blots). Biomechanical data was interpreted using a linear regression analysis of repeated measures and an ANOVA analysis of variance was used for molecular data. Significance was defined at p
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PAPER 011: MODIFYING Joint Capsule CELLS CONTRACTILE PROPERTIES
2010Co-Authors: Kevin A. Hildebrand, Mei Zhang, David A. HartAbstract:Purpose: To determine if cells isolated from the rabbit Joint Capsule in post-traumatic Joint contractures have altered responses to stimuli and inhibitors. Method: The right knee of three rabbits had cortical windows removed from the femoral condyles followed by 4 weeks of immobilization, a recently developed model of post-traumatic contractures. The contralateral knee served as an unoperated control. Primary cells (2.5 × 105 cells/ml) isolated from the posterior Capsule were mixed with neutralized bovine collagen solution and then cast into tissue culture plate wells. Gelation occurred overnight and then the cells were treated with 1% serum replacement (control), 10 ng/mL TGF-beta1, and the TGF-beta1 receptor kinase inhibitor SB431542 at 10 microM or 0.1 microM. Gel contraction was measured at 24 post release from the edges of the well using captured images of the gels and computer software. Results: In all groups the contracture (injured) knees displayed significantly greater collagen gel contraction than control Capsule cells. The addition of the TGF-beta1 increased, while SB431542 at the higher dose decreased, the extent of contraction by contracture and control cells. The TGF-beta1 contraction effect was neutralized by the addition of the inhibitor at the higher dose. In terms of sensitivity to the manipulations, the contracture Capsule cells had greater responses to the stimulant and inhibitor. Conclusion: This work is significant as this is the first description of Joint Capsule cell properties. In post-traumatic contractures, these cells have an intrinsically increased contraction ability at baseline conditions (serum replacement), and these cells also have heightened responses to TGF-beta1 and the TGF-beta1 receptor kinase inhibitor SB431542, a known pathway associated with fibrosis. These results support future work modifying this pathway directly, or by manipulating cells that liberate TGF-beta1. One such strategy would be to prevent mast cells from degranulating as they are a source of TGF-beta1 and other profibrotic growth factors, cytokines and enzymes.
David A. Hart - One of the best experts on this subject based on the ideXlab platform.
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THE EFFECT OF SUBSTANCE P ON Joint Capsule CELL FUNCTION IN COLLAGEN GEL ASSAYS
2012Co-Authors: Kevin A. Hildebrand, Mei Zhang, Paul T. Salo, David A. HartAbstract:Purpose Recent work has shown that Joint contracture severity can be decreased with the mast cell stabilizer ketotifen in association with decreased numbers of myofibroblasts and mast cells in the Joint Capsule of a rabbit model of post-traumatic contractures. Neuropeptides such as Substance P (SP) can induce mast cells to release growth factors. Using a gel contraction assay, we test the hypothesis that Joint Capsule cell-mediated contraction of a collagen gel can be enhanced with SP, but the effect is magnified in the presence of mast cells. Method Anterior elbow Joint Capsules were obtained at the time of surgical release from 2 men (age 34 and 54) and 1 woman (age 40) with chronic (> 1 year) post-traumatic Joint contractures. The human mast cell line HMC-1 (Mayo Clinic, Rochester), SP and the NK1 receptor antagonist RP67580 (Sigma, Oakville, ON) were used. NK1 is the SP receptor. Neutralized Collagen solution composed with 58% Vitrogen 100 purified collagen mixed with HMC-1 cells only (7.5 105), human Capsule cells (2.5 105), or human Capsule cells (2.5 105) and 7.5 105 mast cells (1:3) were cast into 24- well tissue culture plates. In some experiments, SP (1 × 10 −5 M) +/− RP67580 (0.5 mM) were added. The gels were maintained with 0.5 ml DMEM composed with 2% BSA and incubated at 37C for 12 h for gelation to occur. The gels were then detached from the wall and the bottom of culture plate wells, and photographed at regular intervals up to 72 hours. Gel contraction studies were carried out on passage 4 and done in triplicate for each patient. The average value of each patients triplicate was combined to give a mean contraction at each time point. Statistical analysis involved an ANOVA with posthoc Bonferroni correction. P Results Mast cells alone or with SP were unable to contract collagen gels. Joint Capsule cells were able to contract the collagen gels and this was enhanced in the presence of SP, although not statistically significant. Joint Capsule cells combined with mast cells enhanced the gel contraction more than Joint Capsule cells alone or with SP (p Conclusion The in vitro experiment shows that Joint Capsule cell function, in the form of collagen gel contraction, is modified by the presence of mast cells and neuropeptides. These findings are significant as they strengthen the hypothesis that a myofibroblast mast cell neuropeptide fibrosis axis may be contributing to the Joint Capsule changes underling the loss of motion in post-traumatic Joint contractures. In vivo studies with the rabbit model of post-traumatic contractures will be performed using the compounds examined in the current study.
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The mast cell stabilizer ketotifen reduces Joint Capsule fibrosis in a rabbit model of post-traumatic Joint contractures
Inflammation Research, 2012Co-Authors: Michael J. Monument, Mei Zhang, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Objectives Using a rabbit model of post-traumatic Joint contractures, we investigated whether treatment with a mast cell stabilizer after Joint injury would lessen the molecular manifestations of Joint Capsule fibrosis. Methods Surgical Joint injury was used to create stable post-traumatic contractures of the knee in skeletally mature New Zealand white rabbits. Four groups of animals were studied: a non-operated control group ( n = 8), an operated contracture group ( n = 13) and two operated groups treated with the mast cell stabilizer, ketotifen, at doses of 0.5 mg/kg ( n = 9) and 1.0 mg/kg ( n = 9) twice daily. Joint Capsule fibrosis was assessed by quantifying the mRNA and protein levels of α-SMA, tryptase, TGF-β1, collagen I and collagen III. Significance was tested using an ANOVA analysis of variance. Results The protein and mRNA levels of α-SMA, TGF-β1, tryptase and collagen I and III were significantly elevated in the operated contracture group compared to control ( p
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The mast cell stabilizer ketotifen reduces Joint Capsule fibrosis in a rabbit model of post-traumatic Joint contractures
Inflammation Research, 2011Co-Authors: Michael J. Monument, Mei Zhang, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Objectives Using a rabbit model of post-traumatic Joint contractures, we investigated whether treatment with a mast cell stabilizer after Joint injury would lessen the molecular manifestations of Joint Capsule fibrosis.
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3. THE MAST CELL STABILIZER KETOTIFEN, SIGNIFICANTLY REDUCES CONTRACTURE SEVERITY AND MOLECULAR MANIFESTATIONS OF Joint Capsule FIBROSIS IN A RABBIT MODEL OF POSTTRAUMATIC Joint CONTRACTURES
2011Co-Authors: Michael J. Monument, David A. Hart, A. D. Befus, Paul T. Salo, Kevin A. HildebrandAbstract:Purpose: To determine if mast cell activity is vital to the induction of Joint Capsule fibrosis and contracture formation in a rabbit model of posttraumatic Joint contracture. Method: To reproducibly induce Joint contractures, we used a model of surgical injury and immobilization of the knee in skeletally mature New Zealand white rabbits. Four animals groups were studied: a non-operative control group (CON), an operative contracture group (ORC) and two-operative groups treated with a mast cell stabilizer, Ketotifen fumarate at doses of 0.5mg/kg (KF0.5) and 1.0mg/kg (KF1.0) twice daily subcutaneously, respectively. Animals were sacrificed after 8 weeks of immobilization. Flexion contractures (biomechanics), cellular counts of myofibroblasts and mast cells within the Joint Capsule (immunohistochemistry) and the Joint Capsule protein expression of TGF-β1, collagen I and III were quantified (western blots). Biomechanical data was interpreted using a linear regression analysis of repeated measures and an ANOVA analysis of variance was used for molecular data. Significance was defined at p
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PAPER 011: MODIFYING Joint Capsule CELLS CONTRACTILE PROPERTIES
2010Co-Authors: Kevin A. Hildebrand, Mei Zhang, David A. HartAbstract:Purpose: To determine if cells isolated from the rabbit Joint Capsule in post-traumatic Joint contractures have altered responses to stimuli and inhibitors. Method: The right knee of three rabbits had cortical windows removed from the femoral condyles followed by 4 weeks of immobilization, a recently developed model of post-traumatic contractures. The contralateral knee served as an unoperated control. Primary cells (2.5 × 105 cells/ml) isolated from the posterior Capsule were mixed with neutralized bovine collagen solution and then cast into tissue culture plate wells. Gelation occurred overnight and then the cells were treated with 1% serum replacement (control), 10 ng/mL TGF-beta1, and the TGF-beta1 receptor kinase inhibitor SB431542 at 10 microM or 0.1 microM. Gel contraction was measured at 24 post release from the edges of the well using captured images of the gels and computer software. Results: In all groups the contracture (injured) knees displayed significantly greater collagen gel contraction than control Capsule cells. The addition of the TGF-beta1 increased, while SB431542 at the higher dose decreased, the extent of contraction by contracture and control cells. The TGF-beta1 contraction effect was neutralized by the addition of the inhibitor at the higher dose. In terms of sensitivity to the manipulations, the contracture Capsule cells had greater responses to the stimulant and inhibitor. Conclusion: This work is significant as this is the first description of Joint Capsule cell properties. In post-traumatic contractures, these cells have an intrinsically increased contraction ability at baseline conditions (serum replacement), and these cells also have heightened responses to TGF-beta1 and the TGF-beta1 receptor kinase inhibitor SB431542, a known pathway associated with fibrosis. These results support future work modifying this pathway directly, or by manipulating cells that liberate TGF-beta1. One such strategy would be to prevent mast cells from degranulating as they are a source of TGF-beta1 and other profibrotic growth factors, cytokines and enzymes.
In-ho Jeon - One of the best experts on this subject based on the ideXlab platform.
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Topography of sensory receptors within the human glenohumeral Joint Capsule.
Journal of shoulder and elbow surgery, 2020Co-Authors: Erica Kholinne, Dasom Kim, Jae-man Kwak, Yucheng Sun, Hyojune Kim, Kyoung Hwan Koh, In-ho JeonAbstract:Background and hypotheses Sensory receptors in the Joint Capsule are critical for maintaining Joint stability. However, the distribution of sensory receptors in the glenohumeral Joint of the shoulder, including mechanoreceptors and free nerve endings, has not been described yet. This study aimed to describe the distributions of different sensory receptor subtypes in the glenohumeral Joint Capsule. Our hypotheses were as follows: (1) Sensory receptor subtypes would differ in density but follow a similar distribution pattern, and (2) the anterior Capsule would have the highest density of sensory receptors. Methods Six glenohumeral Joint Capsules were harvested from the glenoid to the humeral attachment. The Capsule was divided into 4 regions of interest (anterior, posterior, superior, and inferior) and analyzed using modified gold chloride stain. Sensory receptors as well as free nerve endings were identified and counted under a light microscope from sections of each region of interest. The density of each sensory receptor subtype was calculated relative to Capsule volume. Results Sensory receptors were distributed in the glenohumeral Joint Capsule with free nerve endings. The anterior Capsule exhibited the highest median density of all 4 sensory receptors examined, followed by the superior, inferior, and posterior Capsules. The median densities of these sensory receptor subtypes also significantly differed (P = .007), with type I (Ruffini corpuscles) receptors having the highest density (2.97 U/cm3), followed by type IV (free nerve endings, 2.25 U/cm3), type II (Pacinian corpuscles, 1.40 U/cm3), and type III (Golgi corpuscles, 0.24 U/cm3) receptors. Conclusion Sensory receptor subtypes are differentially expressed in the glenohumeral Joint Capsule, primarily type I and IV sensory receptors. The expression of sensory receptors was dominant in the anterior Capsule, stressing the important role of proprioception feedback for Joint stability. The surgical procedure for shoulder instability should consider the topography of sensory receptors to preserve or restore the proprioception of the shoulder Joint.
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Topography of Sensory Receptors within the Human Glenohumeral Joint Capsule.
Journal of Shoulder and Elbow Surgery, 2020Co-Authors: Erica Kholinne, Dasom Kim, Jae-man Kwak, Yucheng Sun, Hyojune Kim, Kyoung Hwan Koh, In-ho JeonAbstract:Abstract Background Sensory receptors in the Joint Capsule are critical for maintaining Joint stability. However, the distribution of sensory receptors in the glenohumeral Joint of the shoulder, including mechanoreceptors and free nerve endings, has not been described yet. The present study aimed to describe the distributions of different sensory receptor subtypes in the glenohumeral Joint Capsule. Hypotheses (1) Sensory receptor subtypes differ in density but follow a similar distribution pattern, and (2) the anterior Capsule has the highest density of sensory receptors. Methods Six glenohumeral Joint Capsules were harvested from the glenoid to the humeral attachment. The Capsule was divided into four regions of interest (ROIs) (anterior, posterior, superior, and inferior) and analyzed using modified gold chloride stain. Sensory receptors as well as free nerve endings were identified and counted under a light microscope from sections of each ROI. The density of each sensory receptor subtype was calculated relative to Capsule volume. Results Sensory receptors were distributed in the glenohumeral Joint Capsule with free nerve endings. The anterior Capsule exhibited the highest median density of all four sensory receptors examined, followed by the superior, inferior, and posterior Capsules. The median densities of these sensory receptor subtypes also significantly differed (p = 0.007), with Type I (Ruffini corpuscles) receptors having the highest density (2.97 units/cm3), followed by Type IV (free nerve endings) receptors (2.25 units/cm3), Type II (Pacinian corpuscles) receptors (1.40 units/cm3), and Type III (Golgi corpuscles) receptors (0.24 units/cm3). Conclusion Sensory receptor subtypes are differentially expressed in the glenohumeral Joint Capsule, primarily Type I and IV sensory receptors. The expression of sensory receptors was dominant in the anterior Capsule, stressing the important role of proprioception feedback for Joint stability. The surgical procedure for shoulder instability should consider the topography of sensory receptors to preserve or restore the proprioception of the shoulder Joint. Level of evidence Anatomy Study; Histology
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Neuroanatomical distribution of sensory receptors in the human elbow Joint Capsule.
Shoulder & Elbow, 2018Co-Authors: Erica Kholinne, Maria Florencia Deslivia, Kim Ga Yeong, In-ho JeonAbstract:BackgroundThe topographic arrangement of sensory receptors in the human elbow Joint Capsule is pertinent to their role in the transmission of neural signals. The signals from stimuli in the Joint a...
Akimoto Nimura - One of the best experts on this subject based on the ideXlab platform.
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New insight into the iliofemoral ligament based on the anatomical study of the hip Joint Capsule.
Journal of anatomy, 2019Co-Authors: Masahiro Tsutsumi, Akimoto Nimura, Keiichi AkitaAbstract:The iliofemoral ligament, which plays an important role in hip Joint stability, is formed on the anterosuperior region of the hip Joint Capsule. Although the tendon and deep aponeurosis of the gluteus minimus and iliopsoas are partly connected to the same region of the Capsule, the precise location of the connections between the Joint Capsule and the tendons and deep aponeuroses remains unclear. The locations of the tendinous and aponeurotic connections with the Joint Capsule may clarify whether the iliofemoral ligament can be regarded as the dynamic stabilizer. This study investigated the relationships between the anterosuperior region of the Joint Capsule and the tendon and deep aponeurosis of the gluteus minimus and iliopsoas. Fourteen hips from nine cadavers (five males; four females; mean age at death 76.7 years) were analyzed. Ten hips were macroscopically analyzed, and four were histologically analyzed. During macroscopic analysis, the Joint Capsule was detached from the acetabular margin and the femur, and its local thickness was measured using microcomputed tomography (micro-CT). The gluteus minimus tendon was connected to the Joint Capsule, and the lateral end of this connection was adjoined with the tubercle of the femur at the superolateral end of the intertrochanteric line. The deep aponeurosis of the iliopsoas was also connected to the Joint Capsule, and the inferomedial end of its anterior border corresponded with the inferomedial end of the intertrochanteric line. In the micro-CT analysis, capsular thickening was observed at the base of the connection to the gluteus minimus tendon and at the anterior border of the deep aponeurosis of the iliopsoas. A histological study showed that the gluteus minimus tendon and the deep aponeurosis of the iliopsoas were continuous with the hip Joint Capsule. Based on the morphology of the tendinous and aponeurotic connections, local capsular thickening and histological continuity, the transverse and descending parts of the iliofemoral ligament were the Joint Capsules, with fibers arranged according to the connection with the gluteus minimus tendon and the deep aponeurosis of the iliopsoas, respectively. Therefore, the so-called iliofemoral ligament could be regarded as the dynamic stabilizer, with the ability to transmit the muscular power to the Joint via the capsular complex. This anatomical knowledge provides a better understanding of the hip stabilization mechanism.
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Anatomic study of the medial side of the ankle base on the Joint Capsule: an alternative description of the deltoid and spring ligament
Journal of Experimental Orthopaedics, 2019Co-Authors: Kentaro Amaha, Akimoto Nimura, Atsushi Tasaki, Reiko Yamaguchi, Natnicha Kampan, Kumiko Yamaguchi, Ryuichi Kato, Keiichi AkitaAbstract:Background Adult acquired flatfoot deformity (AAFD) is caused by impaired medial ligamentous structures and posterior tibialis tendon dysfunction (PTTD). Although degeneration and trauma could separately cause AAFD, how these factors interact in the pathomechanism of AAFD is unclear. The Joint Capsule in the medial ankle is considered an important structure, providing passive stability by limiting Joint movement. Previous reports on the Joint Capsule suggest its involvement in pathological changes of the ankle, but because of the high priority placed on the ligaments, few reports address the ankle Joint from the Joint Capsule standpoint. The current study aimed to anatomically examine the medial ankle Joint, focusing on the deltoid and spring ligaments in perspective of the Joint Capsule. Methods We conducted a descriptive anatomical study of 19 embalmed cadavers (mean 82.7 years, range 58 to 99). We included 22 embalmed cadaveric ankles. We detached the Joint Capsule in 16 ankles from the anterior to posteromedial Joint, analyzed the capsular attachments of the ankle and adjacent Joints, and measured the widths of the bony attachments. We histologically analyzed the Joint Capsule using Masson’s trichrome staining in 6 ankles. Results The Capsule could be separated as a continuous sheet, including 3 different tissues. The anterior Capsule was composed of fatty tissue. Between the medial malleolus and talus, the Capsule was strongly connected and was composed of fibrous tissue, normally referred to as the deep deltoid ligament. The tibial attachment formed a steric groove, and the talar side of the attachment formed an elliptical depressed area. On the medial part of the subtalar and talonavicular Joints, the Capsule covered the Joints as cartilaginous tissue, normally referred to as the superomedial ligament of the spring ligament. The outer side of the cartilaginous and fibrous tissue formed the sheath floor of the posterior tibialis tendon. Histological analysis revealed three different tissue types. Conclusions The Capsules of the ankle, subtalar, and talonavicular Joints could be detached as a continuous sheet. The deltoid and the superomedial ligament of the spring ligaments could be interpreted as a part of the continuous Capsule, which had different histological features. Level of evidence Descriptive Laboratory Study.
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Anatomic study of the medial side of the ankle base on the Joint Capsule: an alternative description of the deltoid and spring ligament
Journal of experimental orthopaedics, 2019Co-Authors: Kentaro Amaha, Akimoto Nimura, Atsushi Tasaki, Reiko Yamaguchi, Natnicha Kampan, Kumiko Yamaguchi, Ryuichi Kato, Keiichi AkitaAbstract:Adult acquired flatfoot deformity (AAFD) is caused by impaired medial ligamentous structures and posterior tibialis tendon dysfunction (PTTD). Although degeneration and trauma could separately cause AAFD, how these factors interact in the pathomechanism of AAFD is unclear. The Joint Capsule in the medial ankle is considered an important structure, providing passive stability by limiting Joint movement. Previous reports on the Joint Capsule suggest its involvement in pathological changes of the ankle, but because of the high priority placed on the ligaments, few reports address the ankle Joint from the Joint Capsule standpoint. The current study aimed to anatomically examine the medial ankle Joint, focusing on the deltoid and spring ligaments in perspective of the Joint Capsule. We conducted a descriptive anatomical study of 19 embalmed cadavers (mean 82.7 years, range 58 to 99). We included 22 embalmed cadaveric ankles. We detached the Joint Capsule in 16 ankles from the anterior to posteromedial Joint, analyzed the capsular attachments of the ankle and adjacent Joints, and measured the widths of the bony attachments. We histologically analyzed the Joint Capsule using Masson’s trichrome staining in 6 ankles. The Capsule could be separated as a continuous sheet, including 3 different tissues. The anterior Capsule was composed of fatty tissue. Between the medial malleolus and talus, the Capsule was strongly connected and was composed of fibrous tissue, normally referred to as the deep deltoid ligament. The tibial attachment formed a steric groove, and the talar side of the attachment formed an elliptical depressed area. On the medial part of the subtalar and talonavicular Joints, the Capsule covered the Joints as cartilaginous tissue, normally referred to as the superomedial ligament of the spring ligament. The outer side of the cartilaginous and fibrous tissue formed the sheath floor of the posterior tibialis tendon. Histological analysis revealed three different tissue types. The Capsules of the ankle, subtalar, and talonavicular Joints could be detached as a continuous sheet. The deltoid and the superomedial ligament of the spring ligaments could be interpreted as a part of the continuous Capsule, which had different histological features. Descriptive Laboratory Study.
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An anatomic study on the attachment of the Joint Capsule to the tibia in the lateral side of the knee
Surgical and Radiologic Anatomy, 2018Co-Authors: Hisayo Nasu, Akimoto Nimura, Hitomi Fujishiro, Sara Sugiura, Hideyuki Koga, Keiichi AkitaAbstract:Purpose The purpose of the current study was to examine the width, area, and histological characteristics of the capsular attachment to the tibia in the lateral side of the knee. Methods A total of 27 knees were used in this study. The Joint Capsule of the knee was peeled away from the tibia and the width of the capsular attachment to the tibia was measured by two independent observers using a caliper. Interclass correlation coefficients for each value were calculated to evaluate the validity of the measurement. The capsular attachment to the tibia of the seven knees was histologically analyzed using Masson’s trichrome staining. Results At the posterior border of Gerdy’s tubercle, the capsular attachment was wide; the average width was 8.6 mm (SD 3.0). Toward the posterolateral aspect of the knee, the capsular attachment gradually tapered. Finally, the capsular attachment was linear at the apex of the head of the fibula. Histological analysis at the posterior border of Gerdy’s tubercle revealed developed uncalcified fibrocartilage on the capsular attachment. In contrast, at the apex of the head of the fibula, the Joint Capsule was adhered to the Capsule of the proximal tibiofibular Joint. Fibrous connective tissue was directly attached to the calcified fibrocartilage. Conclusions The attachment width of the knee Joint Capsule at the lateral side varied according to location. We consider that this finding on the capsular attachment will facilitate an understanding of the pathology or mechanism of diseases on the lateral side of the knee Joint.
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Joint Capsule attachment to the coronoid process of the ulna: an anatomic study with implications regarding the type 1 fractures of the coronoid process of the O'Driscoll classification
Journal of shoulder and elbow surgery, 2016Co-Authors: Haruhiko Shimura, Akimoto Nimura, Hisayo Nasu, Hitomi Fujishiro, Junya Imatani, Atsushi Okawa, Keiichi AkitaAbstract:Background The attachment of the anterior Joint Capsule on the ulnar coronoid process is not yet completely understood. The purpose of this study was to clarify the anatomic relationship between the anterior Capsule of the elbow Joint and the tip of the coronoid process. Methods Seventeen embalmed elbows were used for this anatomic study. The anterior Capsule of the elbow Joint was reflected, and the attachment of the Capsule on the coronoid process was exposed. The attachment of the Joint Capsule on the coronoid process was macroscopically and histologically observed, its relationship to the coronoid tip was assessed, and the length of the attachment of the Joint Capsule was measured. Results The length of the Capsule attachment at the radial side of the coronoid (11.9 mm) was greater than that at the ulnar side (6.1 mm). The bone thickness on the coronoid tip from the proximal edge of the Joint Capsule attachment was 1.9 mm; together, the cartilage and bone thickness was 4.7 mm. At the radial side of the coronoid, the thickness of the Joint Capsule at the proximal aspect of the attachment of 2 samples was 0.6 mm and 0.3 mm, and that at the tip of the coronoid was 2.6 mm and 1.7 mm, respectively. Conclusions The anterior Capsule of the elbow Joint had a substantial attachment on the radial side of the coronoid process. The subtype 2 tip fractures of the O'Driscoll classification included the Joint Capsule attachment, Joint cartilage, and subchondral bone.
