Initiation Timing of Low-Intensity Pulsed Ultrasound Stimulation for Tendon-Bone Healing in a Rabbit Model

Lü, Hongbin; Chen, Can; Qu, Jin; Chen, Huabin; Chen, Yong; Zheng, Cheng; Wang, Zhanwen; Xu, Danning; Zhou, Jinyan; Zhang, Tao; Qin, Ling; Hu, Jianzhong

doi:10.1177/0363546516651863

Cited by 53 publications

(63 citation statements)

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“…LIPUS is a noninvasive and safe form of mechanical energy that can be delivered into biological tissues and cells as acoustic pressure waves, which has been widely used for clinical applications including bone fracture healing, rehabilitation treatment of tendon, ligament, and cartilage disorders . Furthermore, LIPUS stimulation has been certified and approved by Food and Drug Administration (FDA) in the United States as a safe and effective treatment strategy .…”

Section: Discussionmentioning

confidence: 99%

Bone marrow mesenchymal stem cells stimulated with low‐intensity pulsed ultrasound: Better choice of transplantation treatment for spinal cord injury

Ning

Song

et al. 2018

CNS Neurosci Ther

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Summary Stem cell transplantation, especially treatment with bone marrow mesenchymal stem cells (BMSCs), has been considered a promising therapy for the locomotor and neurological recovery of spinal cord injury (SCI) patients. However, the clinical benefits of BMSCs transplantation remain limited because of the considerably low viability and inhibitory microenvironment. In our research, low‐intensity pulsed ultrasound (LIPUS), which has been widely applied to clinical applications and fundamental research, was employed to improve the properties of BMSCs. The most suitable intensity of LIPUS stimulation was determined. Furthermore, the optimized BMSCs were transplanted into the epicenter of injured spinal cord in rats, which were randomized into four groups: (a) Sham group (n = 10), rats received laminectomy only and the spinal cord remained intact. (b) Injury group (n = 10), rats with contused spinal cord subjected to the microinjection of PBS solution. (c) BMSCs transplantation group (n = 10), rats with contused spinal cord were injected with BMSCs without any priming. (d) LIPUS‐BMSCs transplantation group (n = 10), BMSCs stimulated with LIPUS were injected at the injured epicenter after contusion. Rats were then subjected to behavioral tests, immunohistochemistry, and histological observation. It was found that BMSCs stimulated with LIPUS obtained higher cell viability, migration, and neurotrophic factors expression in vitro. The rate of apoptosis remained constant. After transplantation of BMSCs and LIPUS‐BMSCs postinjury, locomotor function was significantly improved in LIPUS‐BMSCs transplantation group with higher level of brain‐derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the epicenter, and the expression of neurotrophic receptor was also enhanced. Histological observation demonstrated reduced cavity formation in LIPUS‐BMSCs transplantation group when comparing with other groups. The results suggested LIPUS can improve BMSCs viability and neurotrophic factors expression in vitro, and transplantation of LIPUS‐BMSCs could promote better functional recovery, indicating possible clinical application for the treatment of SCI.

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Section: Discussionmentioning

confidence: 99%

Bone marrow mesenchymal stem cells stimulated with low‐intensity pulsed ultrasound: Better choice of transplantation treatment for spinal cord injury

Ning

Song

et al. 2018

CNS Neurosci Ther

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“…Biophysical stimulation describes a series of conservative treatment modalities that can be used to assist in tendon and ligament healing, but is typically only applied in well‐vascularized tissues that have a high likelihood of healing without surgery, or as an adjunct to surgery . These methods include physical therapy, cryotherapy, magnetic fields and ultrasound …”

Section: Therapeutic Approaches To Augment Healing In Tendon and Ligamentioning

confidence: 99%

Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration

Leong

Kator

Clemens

et al. 2019

Journal Orthopaedic Research

138

115

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Ligament and tendon injuries are common problems in orthopedics. There is a need for treatments that can expedite nonoperative healing or improve the efficacy of surgical repair or reconstruction of ligaments and tendons. Successful biologically‐based attempts at repair and reconstruction would require a thorough understanding of normal tendon and ligament healing. The inflammatory, proliferative, and remodeling phases, and the cells involved in tendon and ligament healing will be reviewed. Then, current research efforts focusing on biologically‐based treatments of ligament and tendon injuries will be summarized, with a focus on stem cells endogenous to tendons and ligaments. Statement of clinical significance: This paper details mechanisms of ligament and tendon healing, as well as attempts to apply stem cells to ligament and tendon healing. Understanding of these topics could lead to more efficacious therapies to treat ligament and tendon injuries. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:7–12, 2020

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“…BTI injuries seriously affect the motor function of patients . Histologically, BTI has been divided into four special zones: tendon, non‐mineralized fibrocartilage, mineralized fibrocartilage, and bone . This specialized insertion shows a spatial gradient in composition, structure, and mechanical properties, and thus can effectively transfer loading between mechanically dissimilar tissues, like tendon/ligament to bone .…”

mentioning

confidence: 99%

“…This specialized insertion shows a spatial gradient in composition, structure, and mechanical properties, and thus can effectively transfer loading between mechanically dissimilar tissues, like tendon/ligament to bone . Regrettably, bone‐tendon (B‐T) healing is the slowest in comparison with bone fracture or tendon rapture . The reasons for this complicated healing may be due to poor local blood supply of the healing site, integrating on absolutely different tissues, and easy to fiber scar regeneration .…”

mentioning

confidence: 99%

“…Regrettably, bone‐tendon (B‐T) healing is the slowest in comparison with bone fracture or tendon rapture . The reasons for this complicated healing may be due to poor local blood supply of the healing site, integrating on absolutely different tissues, and easy to fiber scar regeneration . Therefore, promotion of B‐T healing is meaningful and urgent in sports medicine.…”

mentioning

confidence: 99%

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Comparative Evaluation of the Book‐Type Acellular Bone Scaffold and Fibrocartilage Scaffold for Bone‐Tendon Healing

Tang

Liu

et al. 2019

Journal Orthopaedic Research

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Bone-tendon (B-T) healing is a clinical challenge due to its limited regeneration capability. Fibrocartilage regeneration and bone formation at the healing site are two critical factors for B-T healing. Promoting fibrocartilage regeneration and bone formation by tissue-engineering may be a promising treatment strategy. In this study, we innovatively fabricated two kinds of acellular scaffolds from bone or fibrocartilage tissues, namely the book-type the acellular bone scaffold (BABS) and the book-type acellular fibrocartilage scaffold (BAFS). Histologically, the two scaffolds well preserved the native extracellular matrix (ECM) structure without cellular components. In vitro studies showed BABS is superior in osteogenic inducibility, while BAFS has good chondrogenic inducibility. To comparatively investigate the efficacy on B-T healing, the BABS or BAFS were, respectively, implanted into a rabbit partial patellectomy model. Macroscopically, a regenerated bone-tendon insertion (BTI) was bridging the residual patella and patellar-tendon with no signs of infection and osteoarthritis. Radiologically, more new bone was formed at the healing interface in the BABS group as compared with the BAFS or control (CTL) groups (p < 0.05). Histologically, at postoperative week 16, histological scores were significantly better for regenerated fibrocartilage in the BAFS group or BABS group compared with the CTL group, but the BAFS group showed a significantly larger score than the BABS groups (p < 0.05). Biomechanical evaluation indicated a higher failure load and stiffness were shown in the BAFS group than those in the BABS or CTL groups at week 16 (p < 0.05). This study indicated that the BAFS is a more promising scaffold for B-T healing in comparison with the BABS.

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Initiation Timing of Low-Intensity Pulsed Ultrasound Stimulation for Tendon-Bone Healing in a Rabbit Model

Abstract: The findings of the study may help optimize the initiation timing of LIPUS for T-B healing.

Cited by 53 publications

References 50 publications

Bone marrow mesenchymal stem cells stimulated with low‐intensity pulsed ultrasound: Better choice of transplantation treatment for spinal cord injury

Bone marrow mesenchymal stem cells stimulated with low‐intensity pulsed ultrasound: Better choice of transplantation treatment for spinal cord injury

Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration

Comparative Evaluation of the Book‐Type Acellular Bone Scaffold and Fibrocartilage Scaffold for Bone‐Tendon Healing

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