The effects of Low-intensity Pulsed Ultrasound on tendon-bone healing in a transosseous-equivalent sheep rotator cuff model

Lovric, Vedran; Ledger, Michael; Goldberg, J.; Harper, Wade; Bertollo, Nicky; Pelletier, Matthew H.; Oliver, Rema A.; Yu, Youcheng; Walsh, William R.

doi:10.1007/s00167-012-1972-z

Cited by 37 publications

(30 citation statements)

References 52 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…VEGF also plays an important role in normal and abnormal neovascularization [11,12]. Prior studies have shown that LIPUS stimulates the production of VEGF in vitro and in vivo [21,27]. However, in our study there was no major difference in VEGF levels between the two groups.…”

Section: Discussioncontrasting

confidence: 80%

See 1 more Smart Citation

Low-intensity Pulsed Ultrasound Enhances Bone Repair in a Rabbit Model of Steroid-associated Osteonecrosis

Zhu

Cai

Lin

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Steroids are a leading cause of femoral head osteonecrosis. Currently there are no medications available to prevent and/or treat steroid-associated osteonecrosis. Low-intensity pulsed ultrasound (LIPUS) was approved by the FDA for treating delayed union of bone fractures. Some studies have reported that LIPUS can enhance bone formation and local blood flow in an animal model of fracture healing. However, whether the effect of osteogenesis and neovascularization by LIPUS can enhance the repair progress in steroid-associated osteonecrosis is unknown.Questions/purposes We hypothesized that LIPUS may facilitate osteogenesis and neovascularization in the reparative processes of steroid-associated osteonecrosis. Using a rabbit animal model, we asked whether LIPUS affects (1) bone strength and trabecular architecture; (2) blood vessel number and diameter; and (3) BMP-2 and VEGF expression. Methods Bilateral femoral head necrosis was induced by lipopolysaccharide and methylprednisolone in 24 rabbits. The left femoral heads of rabbits received LIPUS therapy (200 mW/cm 2 ) for 20 minutes daily and were classified as the LIPUS group. The right femoral heads of the same rabbits did not receive therapy and were classified as the control group. All rabbits were euthanized 12 weeks after LIPUS therapy. Micro-CT, biomechanical testing, histologic evaluation, immunohistochemistry, quantitative realtime PCR, and Western blot were used for examination of the effects of LIPUS. Results Twelve weeks after LIPUS treatment, the loading strength in the control group was 355 ± 38 N (95% CI, 315-394 N), which was lower (p = 0.028) than that in the LIPUS group (441 ± 78 N; 95% CI, 359-524 N). The bone tissue volume density (bone volume/total volume) in the LIPUS group (49.29% ± 12.37%; 95 % CI, 36.31%-62.27%) was higher (p = 0.022) than that in the control group (37.93% ± 8.37%; 95 % CI, 29.15%-46.72%). The percentage of empty osteocyte lacunae in the LIPUS group (17% ± 4%; 95% CI, 15%-20%) was lower (p = 0.002) than that in the control group (26% ± 9%; 95% CI, 21%-32%). The mineral apposition rate (lm/day) in the LIPUS group (2.3 ± 0.8 lm/day; 95% CI, 1.8 2.8 lm/day) was higher (p = 0.001) than that in the control group (1.6 ± 0.3 lm/day; 95% CL, 1.4-1.8 lm/day). The number of blood vessels in the LIPUS group (7.8 ± 3.6/mm 2 ; 95% CI, 5.5-10.1 mm 2 ) was greater (p = 0.025) than the number in Hanxiao Zhu and Xunzi Cai contributed equally to this work and should be considered as co-first authors.The institution of the authors has received funding from the National Natural Science Foundation of China (Hangzhou, Zhejiang, China) (81101377, 81101345, 81171687, 81371954, 81201414, 81201416, 81401785, 81472113) 123Clin Orthop Relat Res (2015) 473:1830-1839 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® the control group (5.7 ± 2.6/mm 2 ; 95% CI, 4.0-7.3 mm 2 ). Messenger RNA (mRNA) and protein expression of BMP-2 in the LIPUS group (75 ± 7, 95% CI, 70-7...

show abstract

Section: Discussioncontrasting

confidence: 80%

“…VEGF protein expression also was not different (p = 0.0124, Fig. 6) between the LIPUS group (23 ± 6; 95% CI, [19][20][21][22][23][24][25][26][27] and the control group (22 ± 6; 95% CI, 18-26).…”

Section: Bmp-2 and Vegf Expressionmentioning

confidence: 90%

Low-intensity Pulsed Ultrasound Enhances Bone Repair in a Rabbit Model of Steroid-associated Osteonecrosis

Zhu

Cai

Lin

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…In order to enhance native tissue healing and improve surgical outcomes, various non-invasive therapeutics have been utilized post-operatively, including ultrasound and shock wave therapy. 16,21 Advantages of non-invasive therapeutic devices include their ease of use, relatively low cost, and ability to be brought into the patient’s home instead of requiring frequent visits to the clinic. Additionally, their use as a post-operative adjuvant therapy does not interfere with surgical techniques or standard rehabilitation protocols.…”

Section: Introductionmentioning

confidence: 99%

Effects of pulsed electromagnetic field therapy at different frequencies and durations on rotator cuff tendon-to-bone healing in a rat model

Huegel

Choi

Nuss

et al. 2018

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

BACKGROUND Rotator cuff tears affect millions of individuals each year, often requiring surgical intervention. However, repair failure remains common. We have previously shown that pulsed electromagnetic field (PEMF) therapy improved tendon-to-bone healing in a rat rotator cuff model. The purpose of this study was to determine the influence of both PEMF frequency and exposure time on rotator cuff healing. METHODS 210 Sprague Dawley rats underwent acute bilateral supraspinatus injury and repair followed by either Physio-Stim® PEMF or High Frequency PEMF for 1, 3, or 6 hours daily. Control animals did not receive PEMF therapy. Mechanical and histological properties were assessed at 4, 8, and 16 weeks. RESULTS Improvements in different mechanical properties at various endpoints were identified for all treatment modalities when compared to non-treated animals, regardless of PEMF frequency or duration. Of note, one hour of Physio-Stim showed significant improvements in tendon mechanical properties across all time points, including increases in both modulus and stiffness as early as 4 weeks. Collagen organization improved for several of the treatment groups compared to controls. Additionally, improvements in collagen I and fibronectin expression were identified with PEMF treatment. Importantly, no adverse effects were identified in any mechanical or histological property. CONCLUSIONS Overall, results suggest that PEMF has a positive effect on rat rotator cuff healing for each electromagnetic fundamental pulse frequency and treatment duration tested in this study.

show abstract

“…These non-parametric tests were adopted since our data did not present a normal distribution. The specimen number used in this study is similar to or more than other biomechanical studies investigating repair techniques [25, 30, 31]. The significance level was set to P < 0.05.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical Effect of Margin Convergence Techniques: Quantitative Assessment of Supraspinatus Muscle Stiffness

et al. 2016

View full text Add to dashboard Cite

Although the margin convergence (MC) technique has been recognized as an option for rotator cuff repair, little is known about the biomechanical effect on repaired rotator cuff muscle, especially after supplemented footprint repair. The purpose of this study was to assess the passive stiffness changes of the supraspinatus (SSP) muscle after MC techniques using shear wave elastography (SWE). A 30 × 40-mm U-shaped rotator cuff tear was created in 8 cadaveric shoulders. Each specimen was repaired with 6 types of MC technique (1-, 2-, 3-suture MC with/without footprint repair, in a random order) at 30° glenohumeral abduction. Passive stiffness of four anatomical regions in the SSP muscle was measured based on an established SWE method. Data were obtained from the SSP muscle at 0° abduction under 8 different conditions: intact (before making a tear), torn, and postoperative conditions with 6 techniques. MC techniques using 1-, or 2-suture combined with footprint repair showed significantly higher stiffness values than the intact condition. Passive stiffness of the SSP muscle was highest after a 1-suture MC with footprint repair for all regions when compared among all repair procedures. There was no significant difference between the intact condition and a 3-suture MC with footprint repair. MC techniques with single stitch and subsequent footprint repair may have adverse effects on muscle properties and tensile loading on repair, increasing the risk of retear of repairs. Adding more MC stitches could reverse these adverse effects.

show abstract

The effects of Low-intensity Pulsed Ultrasound on tendon-bone healing in a transosseous-equivalent sheep rotator cuff model

Cited by 37 publications

References 52 publications

Low-intensity Pulsed Ultrasound Enhances Bone Repair in a Rabbit Model of Steroid-associated Osteonecrosis

Low-intensity Pulsed Ultrasound Enhances Bone Repair in a Rabbit Model of Steroid-associated Osteonecrosis

Effects of pulsed electromagnetic field therapy at different frequencies and durations on rotator cuff tendon-to-bone healing in a rat model

Biomechanical Effect of Margin Convergence Techniques: Quantitative Assessment of Supraspinatus Muscle Stiffness

Contact Info

Product

Resources

About