Abstract
This study was designed to evaluate the effects of low-intensity pulsed ultrasound on bone regeneration during the bone–tendon junction healing process and to explore the application of synchrotron radiation micro computed tomography in three dimensional visualization of the bone–tendon junction to evaluate the microarchitecture of new trabecular bone. Twenty four mature New Zealand rabbits underwent partial patellectomy to establish a bone–tendon junction injury model at the patella–patellar tendon complex. Animals were then divided into low-intensity pulsed ultrasound treatment (20 min/day, 7 times/week) and placebo control groups, and were euthanized at week 8 and 16 postoperatively (n = 6 for each group and time point). The patella–patellar tendon specimens were harvested for radiographic, histological and synchrotron radiation micro computed tomography detection. The area of the newly formed bone in the ultrasound group was significantly greater than that of control group at postoperative week 8 and 16. The high resolution three dimensional visualization images of the bone–tendon junction were acquired by synchrotron radiation micro computed tomography. Low-intensity pulsed ultrasound treatment promoted dense and irregular woven bone formation at week 8 with greater bone volume fraction, number and thickness of new trabecular bone but with lower separation. At week 16, ultrasound group specimens contained mature lamellar bone with higher bone volume fraction and thicker trabeculae than that of control group; however, there was no significant difference in separation and number of the new trabecular bone. This study confirms that low-intensity pulsed ultrasound treatment is able to promot bone formation and remodeling of new trabecular bone during the bone–tendon junction healing process in a rabbit model, and the synchrotron radiation micro computed tomography could be applied for three dimensional visualization to quantitatively evaluate the microarchitecture of new bone in bone–tendon junction.
Highlights
The bone–tendon junction (BTJ) is a complex anatomical structure composed of bone, fibrocartilage and tendon [1, 2]
As healing time increased from postoperative week 8 to 16, the new trabecular bone pattern changed from woven bone to lamellar bone in the low-intensity pulsed ultrasound (LIPUS) group specimens, showing more advanced remodeling with developed lamellar bone and marrow cavity compared with the control group specimens (Fig 2)
The present study was designed to investigate the effects of LIPUS on new trabecular bone formation during the BTJ healing process in an established partial patellectomy model in rabbits, and to explore the feasibility of application of SR-μCT for 3D visualization of the BTJ and quantitative evaluation of the microarchitecture of new bone at the healing interface
Summary
The bone–tendon junction (BTJ) is a complex anatomical structure composed of bone, fibrocartilage and tendon [1, 2]. This unique transitional zone is considered to transmit stress and dissipate stress concentration [3]. The injury of BTJ is common in trauma and sports exercise, it often occurs in different ligaments, such as rotator cuff, patellar tendon, anterior cruciate ligament, and Achilles tendon [4,5,6]. Since the healing of BTJ includes dissimilar tissues, its repair is slower and more difficult than bone-to-bone or tendon-to-tendon healing [9, 10]. Using a therapeutic approach to enhance the healing of BTJ would be important in basic and clinical research
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