Wilson John J, Lee Kenneth S, Chamberlain Connie, DeWall Ryan, Baer Geoffrey S, Greatens Marcus, Kamps Nicole
Division of Sports Medicine, Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, Wisconsin, 53705, USA.
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, 53705, USA.
J Exp Orthop. 2015 Dec;2(1):5. doi: 10.1186/s40634-014-0018-5. Epub 2015 Mar 1.
Intratendinous injections may have important effects on the properties of collagen microarchitecture, morphology, and subsequent mechanical properties of the injected tendon. The purpose of this study was to examine the effects of intratendinous PRP injections; the injectant retention within tendons, the distribution of intratendinous injectant, and whether intratendinous injection or needle fenestration alters tendon morphology or mechanics.
Controlled Laboratory Study.
In the first part of the study, 18 lamb extensor tendons were selected to receive methylene blue-containing PRP injection (PRP/MB), methylene blue only injection (MB), or needle fenestration. The volume of retained injectant was measured and injectant distribution and tendon morphology were examined microscopically. In the second portion of the study, 18 porcine flexor tendons were divided into control, needle fenestration, or saline injection groups. Young's Modulus was then determined for each tendon under 0-4% strain.
Intratendinous injectant is retained within the tendon. The difference between PRP and PRP/MB groups was not significant (p = 0.78). Intratendinous spread of the injectant solution within the tendon occurs primarily in the proximodistal direction, with very little cross-sectional penetration. Intratendinous injections resulted in microscopic morphology disruption (e.g., separation and disorganization of both the collagen bundles and cellular distribution). There were significant differences in Young's Modulus between control (Ectrl = 2415.48) and injected tendons (Einj = 1753.45) at 4% strain (p = 0.01). There were no differences in Young's Modulus between fenestrated and control tendons.
Intratendinous PRP injections are retained within the tendon, and primarily distributes longitudinally with minimal cross-sectional spread. Intratendinous injections may alter tendon morphology and mechanics.
腱内注射可能对注射肌腱的胶原微结构特性、形态及后续力学性能产生重要影响。本研究旨在探讨腱内注射富血小板血浆（PRP）的效果；注射剂在肌腱内的留存情况、腱内注射剂的分布，以及腱内注射或针刺开窗是否会改变肌腱形态或力学性能。
对照实验室研究。
在研究的第一部分，选取18条羊的伸肌腱，分别接受含亚甲蓝的PRP注射（PRP/MB）、仅注射亚甲蓝（MB）或针刺开窗。测量留存注射剂的体积，并通过显微镜检查注射剂分布和肌腱形态。在研究的第二部分，将18条猪的屈肌腱分为对照组、针刺开窗组或生理盐水注射组。然后在0-4%应变下测定每条肌腱的杨氏模量。
1）留存的注射剂体积；2）注射剂分布；3）注射/开窗后形态和生物力学的改变。
腱内注射剂留存于肌腱内。PRP组和PRP/MB组之间的差异不显著（p = 0.78）。注射剂溶液在肌腱内的纵向扩散主要发生在近远侧方向，横断面渗透极少。腱内注射导致微观形态破坏（如胶原束和细胞分布的分离和紊乱）。在4%应变时，对照组（Ectrl = 2415.48）和注射肌腱组（Einj = 1753.45）的杨氏模量存在显著差异（p = 0.01）。开窗肌腱和对照肌腱的杨氏模量没有差异。
腱内PRP注射剂留存于肌腱内，主要纵向分布，横断面扩散极小。腱内注射可能会改变肌腱形态和力学性能。
