Photochemical Tissue Passivation for Prevention and Treatment of Inflammation and Fibrosis of the Shoulder Capsule

Photochemical Tissue Passivation for Prevention and Treatment of Inflammation and Fibrosis of the Shoulder Capsule R. Giorgino MD1,3, N. Rossi MD1,3, M. Bejar-Chapa MD2,, J.L. Monteiro DDS, PhD1, D.M. Kostyra BS1, G.M. Peretti MD3, M.A. Randolph MAS2, R.W. Redmond PhD1 1Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 2Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 3Department of Biomedical Sciences for Health, University of Milan, Italy. Introduction . • Cast immobilization following supraspinatus transection is an effective methodology for generating a model of frozen shoulder in rats. • Preliminary histology data suggests that PTP is effective in reducing inflammatory response in an immobilized shoulder. • Quantitative scoring for inflammatory markers is in progress. A B C Figure 4: Range of motion analysis of the shoulder. A B C Forty rats underwent acute surgical separation of the right supra-spinatus at its insertion on the humerus, followed by immediate repair with a modified Kessler suture. Animals were then divided into two groups: (1) Cast only. (2) Cast and acute PTP on day zero. Outcomes evaluation (3 and 6 weeks): a) Histologic evaluation of inflammation in shoulder capsule. b) Range of motion analysis. Conclusions Methods Adhesive capsulitis is a condition characterized by inflammation and fibrosis of the capsule of the shoulder. It manifests as pain, stiffness and gradual loss of active and passive glenohumeral motion. The exact cause of the primary frozen shoulder is unknown but secondary causes are related to prolonged immobilization after surgical or conservative treatment of shoulder injury or diseases. Adhesive capsulitis is currently managed by early mobilization of the affected shoulder and medications such as NSAIDs, oral or intraarticular steroids and surgery, with limited success. Previous work from our laboratory has sho
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Adhesive capsulitis is a condition characterized by inflammation and fibrosis of the capsule of the shoulder. It manifests as pain, stiffness and gradual loss of active and passive glenohumeral motion. The exact cause of the primary frozen shoulder is unknown but secondary causes are related to prolonged immobilization after surgical or conservative treatment of shoulder injury or diseases. Adhesive capsulitis is currently managed by early mobilization of the affected shoulder and medications such as NSAIDs, oral or intraarticular steroids and surgery, with limited success. Previous work from our laboratory has shown that photochemical tissue passivation (PTP) is an effective method for reducing inflammation and reduces resultant adhesions in injured tissues such as skin, bowel and tendon. PTP could potentially reduce shoulder inflammation, preventing inflammatory markers from infiltrating the site of treatment, and significantly decreasing capsule thickness and adhesions.