Purpose: This study reports the mechanical and histologic properties of intra-articular tendon–bone
healing with the application of low-intensity pulsed ultrasound (LIPUS) in an ovine
knee model. Methods: A single digital extensor tendon autograft from the right hoof was used as the graft
in 89 adult sheep. Femoral fixation was achieved with an EndoButton (Smith & Nephew
Endoscopy, Andover, MA) and tibial fixation by tying over a bony post. LIPUS treatment
was performed daily for 20 minutes over the femoral and tibial tunnels until sacrifice
in all groups, apart from the 26-week group, which was treated only for the first
12 weeks. Histology was performed at 3, 6, 12, and 26 weeks. Mechanical testing was
performed at 6, 12, and 26 weeks. Results: The LIPUS-treated group showed increased cellular activity at the tendon–bone interface
and general improvement in tendon–bone integration and vascularity. Stiffness and
peak load were greater compared with the control group at 26 weeks after surgery (P < .05). Conclusions: The application of LIPUS appears to improve healing at the tendon–bone interface
for soft tissue grafts fixed with a suspensory fixation technique. Histology supports
a benefit based on increased integration between tendon and bone and a biologically
more active interface, which would account for the improved mechanical properties.
Clinical Relevance: The indications of LIPUS may be expanded to include tendon–bone healing, for example,
in anterior cruciate ligament reconstruction.
Key Words
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Article info
Footnotes
Supported by a grant from Smith & Nephew Endoscopy to the University of New South Wales. The authors report no conflict of interest.
Identification
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© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
