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The Study about Extracorporeal Shock Wave Therapy for Rotator Cuff Injury

Author: ZhuCongYa
Tutor: ZhouHaiBin
School: Suzhou University
Course: Orthopedics
Keywords: Extracorporeal shock wave Tendon bone healing Rotator cuff injury Pathological analysis of Tendon - bone healing Mechanism
CLC: R687.2
Type: Master's thesis
Year: 2011
Downloads: 43
Quote: 0
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Abstract


The first part of the Promotion of extracorporeal shock wave Objective To observe the extracorporeal shock wave (ESW) treatment of rat supraspinatus tendon points reconstructed tendon - bone healing rat supraspinatus tendon - bone healing muscle just rebuild histology. Healthy SD rats (365.6 ± 20.5 g), 35, were randomly divided into 2 groups: the shockwave intervention group (16), model group (16), the remaining three standby (failed to prepare for surgery, infection, accidental death to use ). Ended after the intervention group, model group rat supraspinatus muscle injury reconstruction animal models. Which the intervention group after 2 days before given for a week, once / day of shock wave therapy, the the shockwave energy density flow for 0.16mJ/mm2, a single bolus 500 (5Hz 2kPa); model group not given shock wave therapy . Two groups respectively after one week, two weeks, four weeks, eight weeks from each of the four large mouse this HE staining of tissue sections, observe the junction of the rat supraspinatus tendon bone tissue pathological changes in the situation. HE staining results of tissue sections shows: supraspinatus ended the point reconstruction after 1,2 weeks specimens shows: The organizational structure of the tendon - bone connection was loose, rich in inflammatory cells, capillaries of granulation tissue filling; fibroblasts and collagen The protein content is less. Four weeks after the number of inflammatory cells is less than two weeks, see more nucleus fusiform fibroblasts, class round the cartilage cells hyperplasia, increased collagen content, compared with the previous rules of the arrangement of collagen fibers, collagen fibers of the intervention group specimens Arrange more rules, the reduction in the number of inflammatory cells. Eight weeks after tendon bone interface is connected by a dense connective tissue, a large number of synthetic collagen fibers perpendicular to the longitudinal regularly arranged in the intervention group, the visible part of the region of the collagen fibers - the fiber cartilage tissue - bone tissue changes in the transitional zone, the formation of a similar ligament Direct only point-like structure. Overall, the intervention group tendon-bone interface healing process of healing faster (about 2-4 weeks) compared with the model group. Conclusion 1, SD rats is the ideal choice to establish animal model of rotator cuff injury. , Extracorporeal shock wave on the SD rat supraspinatus muscle TDC early tendon - bone reconstruction model has a significant role in promoting healing. The second part of the extracorporeal shock wave Objective To investigate the biological mechanisms promoting rat supraspinatus tendon bone healing muscle just rebuild ESW biological mechanisms to promote muscle just rebuild SD rat supraspinatus tendon bone healing. Healthy SD rats (383.6 ± 22.75 g), 70, were randomly divided into 2 groups: the shockwave intervention group (32), model group (32), and the remaining six spare. Shock wave intervene in the same way as the first part. The two groups, respectively, at postoperative one week, two weeks, four weeks, eight weeks from each of eight large mouse in this half (4) of the rat using real-time PCR technique, the other half of rats using immunohistochemistry detected observed extracorporeal shock wave on SD rat supraspinatus muscle just rebuild the vascular endothelial growth factor (VEGF), von Willebrand factor (vWF), osteocalcin (OC, BGP) and II collagen (Collagen-Ⅱ impact) expression. Level when the results of the real-time PCR: model group, the expression of VEGF after 1 week was significantly higher, up to two weeks to reach the highest point, and then decreased gradually to four weeks after surgery to 1 week to 8 weeks to injury level before. The intervention group expression trends with model group. 4 weeks after surgery, the rising velocity and peak of VEGF in the intervention group were significantly higher than the model group; vWF at 2 weeks postoperatively expression gradually increased and reached its highest point, to 4 weeks, and subsequently decreased gradually to 8 weeks level when reduced to two weeks. Expression trends with model group for the intervention group at 4 and 8 weeks after the operation, the speed and the peak of the rise in the intervention group was significantly higher than the model group; Collagen-II after two weeks when the expression was significantly increased and reached its highest point, to 4 weeks declined to 8 weeks, remained at higher expression levels. 2,4,8 weeks after surgery, the intervention group Collagen-Ⅱ rising velocity and peak are significantly higher than the model group; osteocalcin OC (BGP) expression increased from two weeks after the operation began, to rapid growth in the four weeks to 8 weeks remained higher trend. 4 and 8 weeks after surgery, the intervention group OC (BGP) rising velocity and peak are significantly higher than the model group, the difference was statistically significant. Immunohistochemistry: each of the detection indicators Over time expression amount gradually increases. vWF, collagen - Ⅱ, osteocalcin at 4 and 8 weeks after surgery was significantly increased compared with the model group, the difference was statistically significant. Conclusion extracorporeal shock wave by adjusting the SD rat supraspinatus muscle just rebuild tendon bone junction of vascular endothelial growth factor, von Willebrand factor, osteocalcin and collagen type II protein expression, enhanced tendon bone junction angiogenesis cartilage tissue regeneration and osteogenesis promoting rat supraspinatus muscle just rebuilt the tendon junction early bone healing.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Muscle and tendon surgery
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