盂肱關節為人體中擁有最大活動範圍也是最為複雜的關節。由於盂肱關節被關節囊與關節韌帶包圍，因此，這些種軟組織是盂肱關節運動時的主要限制，並且提供盂肱關節的穩定度。在被動的盂肱關節運動中(包括外展、旋轉和肱骨頭前後位移)，了解前側盂肱關節囊與關節韌帶於活動中之貢獻是重要的。因此，本研究的目的為驗證前側盂肱關節囊與關節韌於關節被動運動時所扮演的角色。肩關節鬆動術及關節囊熱縮術被用來建立活動度過大及活動度不足的肩關節模型。在第一部分，19個新鮮肩部樣本(在死時的年齡為71.67歲，標準差為13.31歲)被使用於評估經關節鬆動術後關節活動度的變化。在第二部分，9 個新鮮肩部樣本(在死時的年齡為66.25歲，標準差為11.51歲) 被使用於評估經關節囊熱縮術後關節活動度的變化。藉由肱骨頭前後位移的變化、肩關節外展與旋轉角度的變化，評估肩關節鬆動術及關節囊熱縮術的效用，並且了解前側關節囊韌帶於肩關節活動時所扮演的角色。

依結果討論與分析，可得以下結論，在外展最終位置施行前側關節鬆動術後，外展角度會增加 (從0.4º到1.2º)。在外展0º與40º的位置將肱骨外旋轉後施行前側關節活動術，外旋轉角度亦增加(1.68º和0.85º)。關節鬆動術應施行於正確的位置才有其效用，亦即其所作用的關節囊韌帶若是在較緊繃的狀態下被治療，應可得到較佳的效果。在施行關節囊熱縮術後，結果顯示肱骨前側位移減少1.24mm，肱骨後側位移減少1.80mm，外旋轉減少3.93º ，內旋轉減少2.60º，外展角度減少3.15º。施行前側關節囊熱縮術有降低盂肱關節活動度的潛能。本研究亦提供證據支持前側關節囊韌帶為主要抑制肱骨頭前向位移及肱骨外旋轉的機轉。

The glenohumeral joint has the greatest mobility among all human joints. The osseous components of this joint is connected by the capsule and the glenohumeral ligaments. These soft tissues are the main passive constraints of the glenohumeral motion and provide the end range stability for the glenohumeral joint. It is important to understand the contribution of the anterior capsular ligament of the glenohumeral joint during passive movements including abduction, rotation and humeral head translation. The purpose of this study was to clarify the role of the anterior capsular ligament during glenohumeral passive movements. Translational joint mobilization technique and thermal capsulorrhaphy were used to create the models with hyper- and hypo-mobility in the current study. Nineteen fresh frozen shoulder specimens (age at time of death: 71.67±13.31 yrs, Mean±SD) were used in the first experiment to evaluate the changes of the mobility of the glenohumeral joint due to joint mobilization. Other nine specimens (age at the time of death: 66.25±11.51 yrs, Mean±SD) were used in the second experiment to assess the changes in mobility of the glenohumeral joint after thermal capsulorrhaphy. The peak displacements of the humeral head at 80 N, range of motion (ROM) of abduction at 4 N-m and those rotation at 2 N-m were considered as the mobility outcome measures to evaluate the effects of the mobilization and thermal capsulorrhaphy on the glenohumeral joint.
The results showed that increases in abduction ROM (from 0.4 to 1.2°) were found because of dorsal and ventral mobilization at end range position of abduction. Range of motion of lateral rotation was increased following ventral translational mobilization in laterally rotated position at neutral (1.68°) and resting (0.85°) position of abduction. The results suggest that dorsal or ventral translational mobilization performed at the correct position where the targeted capsular tissue was tightened is an effective treatment for joint with hypomobility. After anterior thermal capsulorrhaphy, significant decreases were found in displacements (-1.80 mm in dorsal direction and -1.24 mm in ventral direction), rotation range of motion (-3.93° in lateral rotation and -2.60° in medial rotation), and abduction range of motion (-3.15°). The anterior thermal capsulorrhaphy has potential to reduce the translations of the humeral head as well as the rotational range of motion of the glenohumeral joint. The anterior displacement of the humeral head was increased after mobilization and decreased after thermal capsulorrhaphy in this study which appear to support the anterior capsular ligaments were the main constraint and provided joint stability in the anterior direction of the glenohumeral joint.

1. Donatelli, R., Functional anatomy and mechanics, in Physical therapy of the shoulder, R. Donatelli, Editor. 1997, Churchill Livingstone: New York.
2. Poppen, N.K. and Walker, P.S., Normal and abnormal motion of the shoulder. J Bone Joint Surg Am, 1976. 58(2): p. 195-201.
3. Harryman, D.T., 2nd, Sidles, J.A., Clark, J.M., McQuade, K.J., Gibb, T.D., and Matsen, F.A., 3rd, Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am, 1990. 72(9): p. 1334-43.
4. Matzen, F.A. and Zuckerman, J., Biomechanics of the shoulder, in Basic biomechanics of the musculoskeletal system, M. Nordin and V.H. Frankel, Editors. 2001, Lippincott Williams & Wilkins: Philadelphia.
5. Terry, G.C., Hammon, D., France, P., and Norwood, L.A., The stabilizing function of passive shoulder restraints. Am J Sports Med, 1991. 19(1): p. 26-34.
6. Rockwood Jr., C.A. and Matsen III, F.A., The Shoulder. 2nd ed. 1990, Philadelphia: Saunders.
7. Bowen, M.K. and Warren, R.F., Ligamentous control of shoulder stability based on selective cutting and static translation experiments. Clin Sports Med, 1991. 10(4): p. 757-82.
8. Curl, L.A. and Warren, R.F., Glenohumeral joint stability. Selective cutting studies on the static capsular restraints. Clin Orthop, 1996(330): p. 54-65.
9. Debski, R.E., Sakone, M., Woo, S.L., Wong, E.K., Fu, F.H., and Warner, J.J., Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading. J Shoulder Elbow Surg, 1999. 8(4): p. 324-9.
10. Debski, R.E., Wong, E.K., Woo, S.L., Sakane, M., Fu, F.H., and Warner, J.J., In situ force distribution in the glenohumeral joint capsule during anterior-posterior loading. J Orthop Res, 1999. 17(5): p. 769-76.
11. Hsu, A.T., Hedman, T., Chang, J.H., Vo, C., Ho, L., Ho, S., and Chang, G.L., Changes in abduction and rotation range of motion in response to simulated dorsal and ventral translational mobilization of the glenohumeral joint. Phys Ther, 2002. 82(6): p. 544-56.
12. O'Brien, S.J., Schwartz, R.S., Warren, R.F., and Torzilli, P.A., Capsular restraints to anterior-posterior motion of the abducted shoulder: a biomechanical study. J Shoulder Elbow Surg, 1995. 4(4): p. 298-308.
13. Hoffmeyer, P., Browne, A., Korinek, S., Morrey, B.F., and An, K.N., Stabilizing mechanism of the glenohumeral ligaments. Biomed Sci Instrum, 1990. 26: p. 49-52.
14. Itoi, E., Motzkin, N.E., Morrey, B.F., and An, K.N., The static rotator cuff does not affect inferior translation of the humerus at the glenohumeral joint. J Trauma, 1999. 47(1): p. 55-9.
15. Itoi, E., Berglund, L.J., Grabowski, J.J., Naggar, L., Morrey, B.F., and An, K.N., Superior-inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clin Proc, 1998. 73(6): p. 508-15.
16. Itoi, E., Hsu, H.C., and An, K.N., Biomechanical investigation of the glenohumeral joint. J Shoulder Elbow Surg, 1996. 5(5): p. 407-24.
17. Hsu, A.T., Ho, L., Chang, J.H., Chang, G.L., and Hedman, T., Characterization of tissue resistance during a dorsally directed translational mobilization of the glenohumeral joint. Arch Phys Med Rehabil, 2002. 83(3): p. 360-6.
18. Clayton, L., Taber's cyclopedic medical dictionary. 1977, Philadelphia: FA Davis.
19. Kaltenborn, F.M., Evjenth, O., Kaltenborn, T.B., Morgan, D., and Vollowitz, E., Manual mobilization of the joints :/the Kaltenborn method of joint examination and treatment. 2002, Oslo: Olaf Norlis Bokhandel.
20. Hsu, A.T., Chang, J.H., and Chang, C.H., Determining the resting position of the glenohumeral joint: a cadaver study. J Orthop Sports Phys Ther, 2002. 32(12): p. 605-12.
21. Turkel, S.J., Panio, M.W., Marshall, J.L., and Girgis, F.G., Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am, 1981. 63(8): p. 1208-17.
22. Ovesen, J. and Nielsen, S., Stability of the shoulder joint. Cadaver study of stabilizing structures. Acta Orthop Scand, 1985. 56(2): p. 149-51.
23. Ovesen, J. and Nielsen, S., Anterior and posterior shoulder instability. A cadaver study. Acta Orthop Scand, 1986. 57(4): p. 324-7.
24. Ovesen, J. and Nielsen, S., Posterior instability of the shoulder. A cadaver study. Acta Orthop Scand, 1986. 57(5): p. 436-9.
25. Wilk, K.E., Arrigo, C.A., and Andrews, J.R., Current concepts: the stabilizing structures of the glenohumeral joint. J Orthop Sports Phys Ther, 1997. 25(6): p. 364-79.
26. Conroy, D.E. and Hayes, K.W., The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther, 1998. 28(1): p. 3-14.
27. Corso, G., Impingement relief test: an adjunctive procedure to traditional assessment of shoulder impingement syndrome. J Orthop Sports Phys Ther, 1995. 22(5): p. 183-92.
28. Ekelund, A.L. and Rydell, N., Combination treatment for adhesive capsulitis of the shoulder. Clin Orthop, 1992(282): p. 105-9.
29. Kamkar, A., Irrgang, J.J., and Whitney, S.L., Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther, 1993. 17(5): p. 212-24.
30. McClure, P.W. and Flowers, K.R., Treatment of limited shoulder motion using an elevation splint. Phys Ther, 1992. 72(1): p. 57-62.
31. Placzek, J.D., Roubal, P.J., Freeman, D.C., Kulig, K., Nasser, S., and Pagett, B.T., Long-term effectiveness of translational manipulation for adhesive capsulitis. Clin Orthop, 1998(356): p. 181-91.
32. Placzek, J.D., Roubal, P.J., Kulig, K., Pagett, B.T., and Wiater, J.M., Theory and technique of translational manipulation for adhesive capsulitis. Am J Orthop, 2004. 33(4): p. 173-9.
33. Roubal, P.J., Dobritt, D., and Placzek, J.D., Glenohumeral gliding manipulation following interscalene brachial plexus block in patients with adhesive capsulitis. J Orthop Sports Phys Ther, 1996. 24(2): p. 66-77.
34. Weiser, H.I., Painful primary frozen shoulder mobilization under local anesthesia. Arch Phys Med Rehabil, 1977. 58(9): p. 406-8.
35. Maitland, G.D., Peripheral manipulation. 3rd ed. 1991, Boston: Butterworths-Heinemann.
36. Edmond, S.L., Manipulation and mobilization: extremities and spinal techniques. 1993, St Louis: Mosby.
37. Debski, R.E., Wong, E.K., Woo, S.L., Fu, F.H., and Warner, J.J., An analytical approach to determine the in situ forces in the glenohumeral ligaments. J Biomech Eng, 1999. 121(3): p. 311-5.
38. Hsu, A.T., Ho, L., Ho, S., and Hedman, T., Immediate response of glenohumeral abduction range of motion to a caudally directed translational mobilization: a fresh cadaver simulation. Arch Phys Med Rehabil, 2000. 81(11): p. 1511-6.
39. Itoi, E., Newman, S.R., Kuechle, D.K., Morrey, B.F., and An, K.N., Dynamic anterior stabilisers of the shoulder with the arm in abduction. J Bone Joint Surg Br, 1994. 76(5): p. 834-6.
40. Kivimaki, J. and Pohjolainen, T., Manipulation under anesthesia for frozen shoulder with and without steroid injection. Arch Phys Med Rehabil, 2001. 82(9): p. 1188-90.
41. Rubin, B.D. and Kibler, W.B., Fundamental principles of shoulder rehabilitation: conservative to postoperative management. Arthroscopy, 2002. 18(9 Suppl 2): p. 29-39.
42. An, Y.H. and Friedman, R.J., Multidirectional instability of the glenohumeral joint. Orthop Clin North Am, 2000. 31(2): p. 275-85.
43. Bokor, D.J., Conboy, V.B., and Olson, C., Anterior instability of the glenohumeral joint with humeral avulsion of the glenohumeral ligament. A review of 41 cases. J Bone Joint Surg Br, 1999. 81(1): p. 93-6.
44. Burkart, A.C. and Debski, R.E., Anatomy and function of the glenohumeral ligaments in anterior shoulder instability. Clin Orthop, 2002(400): p. 32-9.
45. Burkhead, W.Z., Jr. and Rockwood, C.A., Jr., Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am, 1992. 74(6): p. 890-6.
46. Cleeman, E. and Flatow, E.L., Shoulder dislocations in the young patient. Orthop Clin North Am, 2000. 31(2): p. 217-29.
47. Mohtadi, N.G., Advances in the understanding of anterior instability of the shoulder. Clin Sports Med, 1991. 10(4): p. 863-70.
48. Ong, B.C., Sekiya, J.K., and Rodosky, M.W., Shoulder injuries in the athlete. Curr Opin Rheumatol, 2002. 14(2): p. 150-9.
49. Samilson, R.L. and Prieto, V., Posterior dislocation of the shoulder in athletes. Clin Sports Med, 1983. 2(2): p. 369-78.
50. Rowe, C.R., Prognosis in dislocations of the shoulder. J Bone Joint Surg Am, 1956. 38-A(5): p. 957-77.
51. Dines, D.M. and Levinson, M., The conservative management of the unstable shoulder including rehabilitation. Clin Sports Med, 1995. 14(4): p. 797-816.
52. Breit, R., Wills, E.J., and Bonar, F., Electrothermally arthroscopic capsulorrhaphy: histology and electron microscopy after revision surgery. J Shoulder Elbow Surg, 2004. 13(2): p. 226-9.
53. Clark, G.J., Erickson, K.K., and Mikutis, J., Thermal capsulorrhaphy for acute or chronic shoulder instability. Aorn J, 2001. 74(6): p. 809-15, 817; quiz 818-21, 823-4.
54. Cole, B.J. and Warner, J.J., Arthroscopic versus open Bankart repair for traumatic anterior shoulder instability. Clin Sports Med, 2000. 19(1): p. 19-48.
55. Coughlin, L., Rubinovich, M., Johansson, J., White, B., and Greenspoon, J., Arthroscopic staple capsulorrhaphy for anterior shoulder instability. Am J Sports Med, 1992. 20(3): p. 253-6.
56. Ferretti, A., De Carli, A., Calderaro, M., and Conteduca, F., Open capsulorrhaphy with suture anchors for recurrent anterior dislocation of the shoulder. Am J Sports Med, 1998. 26(5): p. 625-9.
57. Gartsman, G.M., Roddey, T.S., and Hammerman, S.M., Arthroscopic treatment of anterior-inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am, 2000. 82-A(7): p. 991-1003.
58. Gerber, A. and Warner, J.J., Thermal capsulorrhaphy to treat shoulder instability. Clin Orthop, 2002(400): p. 105-16.
59. Giffin, J.R., Annunziata, C.C., and Bradley, J.P., Thermal capsulorrhaphy for instability of the shoulder: multidirectional and posterior instabilities. Instr Course Lect, 2001. 50: p. 23-8.
60. Hawkins, R.J. and Karas, S.G., Arthroscopic stabilization plus thermal capsulorrhaphy for anterior instability with and without Bankart lesions: the role of rehabilitation and immobilization. Instr Course Lect, 2001. 50: p. 13-5.
61. Hayashi, K. and Markel, M.D., Thermal capsulorrhaphy treatment of shoulder instability: basic science. Clin Orthop, 2001(390): p. 59-72.
62. Levitz, C.L., Dugas, J., and Andrews, J.R., The use of arthroscopic thermal capsulorrhaphy to treat internal impingement in baseball players. Arthroscopy, 2001. 17(6): p. 573-7.
63. Lusardi, D.A., Wirth, M.A., Wurtz, D., and Rockwood, C.A., Jr., Loss of external rotation following anterior capsulorrhaphy of the shoulder. J Bone Joint Surg Am, 1993. 75(8): p. 1185-92.
64. Noonan, T.J., Tokish, J.M., Briggs, K.K., and Hawkins, R.J., Laser-assisted thermal capsulorrhaphy. Arthroscopy, 2003. 19(8): p. 815-9.
65. Savoie, F.H., 3rd and Field, L.D., Thermal versus suture treatment of symptomatic capsular laxity. Clin Sports Med, 2000. 19(1): p. 63-75, vi.
66. Tyler, T.F., Calabrese, G.J., Parker, R.D., and Nicholas, S.J., Electrothermally-assisted capsulorrhaphy (ETAC): a new surgical method for glenohumeral instability and its rehabilitation considerations. J Orthop Sports Phys Ther, 2000. 30(7): p. 390-400.
67. Uhorchak, J.M., Arciero, R.A., Huggard, D., and Taylor, D.C., Recurrent shoulder instability after open reconstruction in athletes involved in collision and contact sports. Am J Sports Med, 2000. 28(6): p. 794-9.
68. Wirth, M.A., Groh, G.I., and Rockwood, C.A., Jr., Capsulorrhaphy through an anterior approach for the treatment of atraumatic posterior glenohumeral instability with multidirectional laxity of the shoulder. J Bone Joint Surg Am, 1998. 80(11): p. 1570-8.
69. Wolf, R.S. and Lemak, L.J., Thermal capsulorrhaphy in the treatment of multidirectional instability of the shoulder. J South Orthop Assoc, 2002. 11(2): p. 102-9.
70. Wong, K.L. and Williams, G.R., Complications of thermal capsulorrhaphy of the shoulder. J Bone Joint Surg Am, 2001. 83-A Suppl 2 Pt 2: p. 151-5.
71. Fanton, G.S. and Khan, A.M., Monopolar radiofrequency energy for arthroscopic treatment of shoulder instability in the athlete. Orthop Clin North Am, 2001. 32(3): p. 511-23, x.
72. Pagnani, M.J. and Dome, D.C., Surgical treatment of traumatic anterior shoulder instability in american football players. J Bone Joint Surg Am, 2002. 84-A(5): p. 711-5.
73. Misamore, G.W. and Facibene, W.A., Posterior capsulorrhaphy for the treatment of traumatic recurrent posterior subluxations of the shoulder in athletes. J Shoulder Elbow Surg, 2000. 9(5): p. 403-8.
74. McCarty, E.C., Warren, R.F., Deng, X.H., Craig, E.V., and Potter, H., Temperature along the axillary nerve during radiofrequency-induced thermal capsular shrinkage. Am J Sports Med, 2004. 32(4): p. 909-14.
75. Greis, P.E., Burks, R.T., Schickendantz, M.S., and Sandmeier, R., Axillary nerve injury after thermal capsular shrinkage of the shoulder. J Shoulder Elbow Surg, 2001. 10(3): p. 231-5.
76. Gryler, E.C., Greis, P.E., Burks, R.T., and West, J., Axillary nerve temperatures during radiofrequency capsulorrhaphy of the shoulder. Arthroscopy, 2001. 17(6): p. 567-72.
77. Ellenbecker, T.S. and Mattalino, A.J., Glenohumeral joint range of motion and rotator cuff strength following arthroscopic anterior stabilization with thermal capsulorraphy. J Orthop Sports Phys Ther, 1999. 29(3): p. 160-7.
78. Wilk, K.E., Reinold, M.M., Dugas, J.R., and Andrews, J.R., Rehabilitation following thermal-assisted capsular shrinkage of the glenohumeral joint: current concepts. J Orthop Sports Phys Ther, 2002. 32(6): p. 268-92.
79. Favorito, P.J., Langenderfer, M.A., Colosimo, A.J., Heidt, R.S., Jr., and Carlonas, R.L., Arthroscopic laser-assisted capsular shift in the treatment of patients with multidirectional shoulder instability. Am J Sports Med, 2002. 30(3): p. 322-8.
80. Hecht, P., Hayashi, K., Lu, Y., Fanton, G.S., Thabit, G., 3rd, Vanderby, R., Jr., and Markel, M.D., 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. Am J Sports Med, 1999. 27(6): p. 761-71.
81. Lyons, T.R., Griffith, P.L., Savoie, F.H., 3rd, and Field, L.D., Laser-assisted capsulorrhaphy for multidirectional instability of the shoulder. Arthroscopy, 2001. 17(1): p. 25-30.
82. Wallace, A.L., Hollinshead, R.M., and Frank, C.B., Electrothermal shrinkage reduces laxity but alters creep behavior in a lapine ligament model. J Shoulder Elbow Surg, 2001. 10(1): p. 1-6.
83. Mishra, D.K. and Fanton, G.S., Two-year outcome of arthroscopic bankart repair and electrothermal-assisted capsulorrhaphy for recurrent traumatic anterior shoulder instability. Arthroscopy, 2001. 17(8): p. 844-9.
84. Schaefer, S.L., Ciarelli, M.J., Arnoczky, S.P., and Ross, H.E., Tissue shrinkage with the holmium:yttrium aluminum garnet laser. A postoperative assessment of tissue length, stiffness, and structure. Am J Sports Med, 1997. 25(6): p. 841-8.
85. Osmond, C., Hecht, P., Hayashi, K., Hansen, S., Fanton, G.S., Thabit, G., 3rd, and Markel, M.D., Comparative effects of laser and radiofrequency energy on joint capsule. Clin Orthop, 2000(375): p. 286-94.
86. Hayashi, K., Thabit, G., 3rd, Massa, K.L., Bogdanske, J.J., Cooley, A.J., Orwin, J.F., and Markel, M.D., The effect of thermal heating on the length and histologic properties of the glenohumeral joint capsule. Am J Sports Med, 1997. 25(1): p. 107-12.
87. Hayashi, K., Thabit, G., 3rd, Vailas, A.C., Bogdanske, J.J., Cooley, A.J., and Markel, M.D., The effect of nonablative laser energy on joint capsular properties. An in vitro histologic and biochemical study using a rabbit model. Am J Sports Med, 1996. 24(5): p. 640-6.
88. Hayashi, K., Thabit, G., 3rd, Bogdanske, J.J., Mascio, L.N., and Markel, M.D., The effect of nonablative laser energy on the ultrastructure of joint capsular collagen. Arthroscopy, 1996. 12(4): p. 474-81.
89. Hayashi, K., Peters, D.M., Thabit, G., 3rd, Hecht, P., Vanderby, R., Jr., Fanton, G.S., and Markel, M.D., The mechanism of joint capsule thermal modification in an in-vitro sheep model. Clin Orthop, 2000(370): p. 236-49.
90. Hayashi, K., Markel, M.D., Thabit, G., 3rd, Bogdanske, J.J., and Thielke, R.J., The effect of nonablative laser energy on joint capsular properties. An in vitro mechanical study using a rabbit model. Am J Sports Med, 1995. 23(4): p. 482-7.
91. Hayashi, K., Hecht, P., Thabit, G., 3rd, Peters, D.M., Vanderby, R., Jr., Cooley, A.J., Fanton, G.S., Orwin, J.F., and Markel, M.D., The biologic response to laser thermal modification in an in vivo sheep model. Clin Orthop, 2000(373): p. 265-76.
92. McFarland, E.G., Kim, T.K., Banchasuek, P., and McCarthy, E.F., Histologic evaluation of the shoulder capsule in normal shoulders, unstable shoulders, and after failed thermal capsulorrhaphy. Am J Sports Med, 2002. 30(5): p. 636-42.
93. Medvecky, M.J., Ong, B.C., Rokito, A.S., and Sherman, O.H., Thermal capsular shrinkage: Basic science and clinical applications. Arthroscopy, 2001. 17(6): p. 624-35.
94. Wallace, A.L., Hollinshead, R.M., and Frank, C.B., The scientific basis of thermal capsular shrinkage. J Shoulder Elbow Surg, 2000. 9(4): p. 354-60.
95. Hayashi, K., Massa, K.L., Thabit, G., 3rd, Fanton, G.S., Dillingham, M.F., Gilchrist, K.W., and Markel, M.D., Histologic evaluation of the glenohumeral joint capsule after the laser-assisted capsular shift procedure for glenohumeral instability. Am J Sports Med, 1999. 27(2): p. 162-7.
96. Hayashi, K., Nieckarz, J.A., Thabit, G., 3rd, Bogdanske, J.J., Cooley, A.J., and Markel, M.D., Effect of nonablative laser energy on the joint capsule: an in vivo rabbit study using a holmium:YAG laser. Lasers Surg Med, 1997. 20(2): p. 164-71.
97. White, A.A. and Panjabi, M.M., Clinical biomechanics of the spine. 1990, Philadelphia: Lippincott.
98. Fung, Y.C., Biomechanics :/mechanical properties of living tissues. 1993, New York: Springer-Verlag.
99. Vermeulen, H.M., Obermann, W.R., Burger, B.J., Kok, G.J., Rozing, P.M., and van Den Ende, C.H., End-range mobilization techniques in adhesive capsulitis of the shoulder joint: A multiple-subject case report. Phys Ther, 2000. 80(12): p. 1204-13.
100. Tibone, J.E., McMahon, P.J., Shrader, T.A., Sandusky, M.D., and Lee, T.Q., Glenohumeral joint translation after arthroscopic, nonablative, thermal capsuloplasty with a laser. Am J Sports Med, 1998. 26(4): p. 495-8.
101. Itoi, E., Motzkin, N.E., Browne, A.O., Hoffmeyer, P., Morrey, B.F., and An, K.N., Intraarticular pressure of the shoulder. Arthroscopy, 1993. 9(4): p. 406-13.
102. Warner, J.J., Deng, X.H., Warren, R.F., and Torzilli, P.A., Static capsuloligamentous restraints to superior-inferior translation of the glenohumeral joint. Am J Sports Med, 1992. 20(6): p. 675-85.
103. Kumar, V.P. and Balasubramaniam, P., The role of atmospheric pressure in stabilising the shoulder. An experimental study. J Bone Joint Surg Br, 1985. 67(5): p. 719-21.