Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan.
Kuan-Ta Rehabilitation and Pain Clinic, Taichung 40652, Taiwan.
Foot Ankle Surg. 2019 Apr;25(2):186-192. doi: 10.1016/j.fas.2017.10.007. Epub 2017 Oct 29.
This study investigated the effects of percutaneous soft tissue release (PSTR) performed using a blunt cannula on (1) the inflammatory cells-count, (2) expressions of calcitonin gene-related peptide (CGRP) and (3) substance P (SP) in rabbits with chronic phase of collagenase-induced Achilles tendinopathy.
Thirty-two adult male New Zealand rabbits were randomly divided into four groups: (1) collagenase and PSTR treatment; (2) collagenase and sham-operated PSTR treatment; (3) vehicle-only injection and PSTR treatment; and (4) vehicle-only injection and sham-operated PSTR treatment. Achilles tendon of adult male rabbits was injected with 10μl of collagenase under ultrasonography localization. After 30 days, PSTR was performed using an 18G beauty cosmetic blunt tip micro cannula needle to release the soft tissue and paratenon above the inflamed Achilles tendon. The treated tendons and spinal cords of L5-S2 were harvested 5days after treatment for histological assessment and immunohistochemical analysis.
Histopathological examination revealed that PSTR achieved significant reduction in hypercellularity with pronounced infiltration of immune cells at the site of paratenon in tendons injected with collagenase compared with sham operation (p<0.05). Immunohistochemical analysis also showed marked decrease in expression of CGRP in tendon and SP in dorsal horns after PSTR (p<0.05).
This study showed positive effects in an animal model of chronic tendinopathy, and can be considered a treatment option, but that further research is necessary to determine its role in clinical practice.
本研究旨在探讨使用钝套管进行经皮软组织松解术（PSTR）对胶原酶诱导的兔慢性跟腱病的（1）炎症细胞计数、（2）降钙素基因相关肽（CGRP）表达和（3）P 物质（SP）表达的影响。
32 只成年雄性新西兰兔随机分为 4 组：（1）胶原酶和 PSTR 治疗组；（2）胶原酶和假手术 PSTR 治疗组；（3）仅注射载体和 PSTR 治疗组；和（4）仅注射载体和假手术 PSTR 治疗组。在超声定位下，将 10μl 胶原酶注入成年雄性兔的跟腱。30 天后，使用 18G 美容钝尖微套管针进行 PSTR，以释放炎症跟腱上方的软组织和腱旁组织。治疗后 5 天，采集处理后的跟腱和 L5-S2 脊髓进行组织学评估和免疫组织化学分析。
组织病理学检查显示，与假手术相比，PSTR 可显著减少胶原酶注射部位腱旁组织的高细胞性和免疫细胞浸润（p<0.05）。免疫组织化学分析还显示，PSTR 后肌腱中 CGRP 和背角中 SP 的表达明显减少（p<0.05）。
本研究在慢性腱病动物模型中显示出积极的效果，可以被认为是一种治疗选择，但需要进一步的研究来确定其在临床实践中的作用。
