Comparison of the Acute Inflammatory Response and Proliferation of Dry Needling and Electrolysis Percutaneous Intratissue (Epi) in Healthy Rat Achilles Tendons

Abstract

IntroductionElectrolysis Percutaneous Intratissue (EPI) is a new technique that involves the application of a galvanic current with an acupuncture needle that causes a theoretical local inflammatory process and subsequent tissue repair in the soft tissue. Electrolysis Percutaneous Intratissue (EPI) could promote wound healing. The purpose of this study was to examine the cellular response to Dry Needling versus Electrolysis Percutaneous Intratissue (EPI) after intratendinous treatment in an animal model.MethodsDesign:Controlled laboratory study.Setting.Department of Veterinary. University Complutense of Madrid-Spain.Intervention.Twenty-four male Sprague Dawley adult rats were included in this experiment, weighing 190–240 g. In all cases, healthy Achilles tendons were treated. In the intervention group (n=18), one Achilles tendon was treated with dry needling, and the other was treated with electrolysis percutaneous intratissue. In the control animals (n=6) no intervention was carried out. Twenty four total tendons were treated with dry needling, and 24 tendons with electrolysis percutaneous intratissue, and 12 tendons were the control animals. In the experimental animals, one Achilles tendon was treated with dry needling (two impacts), and the other was treated with EPI 4 mA, 4 segs. and 2 impacts. Animals were euthanized after 0, 1, 3, 8, 14 and 21days after intervention by CO2asphyxiation. Muscle–Achilles tendon–bone units were harvested by transection of the middle part of the gastrocnemius muscle and of the calcaneus. Tendons were harvested and stained using E&H and scored semi-quantitatively for total white blood cells (WBCs), mononuclear cells (macrophages and lymphocytes), polymorphonuclear cells (PMNs), vascularity, fiber structure, and fibrosis.ResultsAfter intervention the macroscopic findings (0 days) inflammatory response and haemorrhage were higher in EPI group versus dry needling. There is no significant difference in the cellularity regardless of the intervention types (dry needling vs EPI) at 0 days after intratendinous intervention. Compared with Dry Needling, Electrolysis Percutaneous Intratissue causes a significantly greater acute inflammatory response at 1 and 3 days after intervention and focal areas of scar tissue. Compared with findings in control specimens, histological analysis of EPI showed a marked inflammatory infiltrate. Histological examination of the repair tendon tissue showed that by 14 days delivery of EPI led to the formation of well-organised, tendinous tissue with large collagen fibres.DiscussionElectrolysis Percutaneous Intratissue can stimulate the tendon biology, initiate an inflammatory response and promote wound healing in normal tendon in rats.Limitations of the study.A limitation of the present study is the use of rat Achilles tendon, which does not accurately reflect human Achilles tendon. Future investigations are necessary to apply these findings to the clinical setting.

Comparative study of treatment interventions for patellar tendinopathy: a protocol for a randomised controlled trial

“…Each session will consist of three needle insertions lasting 3 seconds each. In percutaneous needle electrolysis group (PNE-G) applications, an intensity of 3 mA galvanic current will be used during the 3 seconds that the procedure lasts 19. The dose of 3 mA has demonstrated to be as effective as 6 mA in the treatment of tendinopathy injuries in animal models 18 19.…”

“…In percutaneous needle electrolysis group (PNE-G) applications, an intensity of 3 mA galvanic current will be used during the 3 seconds that the procedure lasts 19. The dose of 3 mA has demonstrated to be as effective as 6 mA in the treatment of tendinopathy injuries in animal models 18 19. In humans, a study conducted in 2016 showed that a dose of 3 mA in PT generated structural changes compatible with tendon regeneration, together with improvement of functionality and pain 22.…”

“…From a biological point of view, it seems reasonable to hypothesise that a patient will obtain benefits thanks to the mechanical effects provided by the needle,16 and that patients may benefit more if the electrolysis effect is added to the mechanical stimuli provided by the needle 19…”

Effectiveness of Percutaneous Electrolysis in Supraspinatus Tendinopathy: A Single-Blinded Randomized Controlled Trial

“…Its mechanism of action is electrolysis, or the separation of ions whose charge is opposite to that of the tissue under treatment. This produces a “controlled” injury and an acute inflammatory response leading to the formation of new, healthy tissue [ 19 ].…”

Ultrasound-guided percutaneous needle electrolysis and rehabilitation and reconditioning program following a hamstring injury reduces “return to play” time in professional soccer players: A case series

“…8 This treatment stimulates a local inflammatory response leading to increased cellular activity and repair of the affected area. 9 The needle is directed at the soft tissue injuries of the musculoskeletal system under direct ultrasound visualization. PNE has proven to be effective in tendinosis, 10 plantar fasciitis, 11 whiplash syndrome, 12 and myofascial pain syndrome 13 however, its effectiveness in acute muscle injury is little known.…”