Huang Mingru, Shao Hong, Zhang Shurong, Gao Han, Feng Sijia, Sun Luyi, Yu Chengxuan, Du Xiner, Chen Jun, Li Yunxia
Sports Medicine Institute of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Am J Sports Med. 2024 Mar;52(3):710-720. doi: 10.1177/03635465231221725. Epub 2024 Feb 14.
Extracorporeal shock wave therapy (ESWT) promotes tissue healing by modulating inflammation, which has implications for meniscal tear healing in the avascular zone.
To evaluate the effects of a single dose of radial ESWT on the healing process and inflammation of the meniscus and knee joints after meniscal tears in the avascular zone.
Controlled laboratory study.
Avascular tears were induced in the medial meniscus (MM) of 72 Sprague-Dawley rats. One week postoperatively, the rats received a single session of radial ESWT with a Power+ handpiece (ESWT group; n = 36) or with a fake handpiece (sham-ESWT group; n = 36). The rats were then euthanized at 2, 4, or 8 weeks postoperatively. The MMs were harvested for analysis of healing (hematoxylin-eosin, safranin O-Fast Green, and collagen type 2 staining) and inflammation (interleukin [IL]-1β and IL-6 staining). Lateral menisci and synovia were obtained to evaluate knee joint inflammation (enzyme-linked immunosorbent assay of IL-1β and IL-6). Cartilage degeneration was assessed in the femurs and tibial plateaus using safranin O-Fast Green staining.
The ESWT group showed significantly better meniscal healing scores than the sham-ESWT group at 4 ( = .0066) and 8 ( = .0050) weeks postoperatively. The IL-1β level was significantly higher in the sham-ESWT group than in the ESWT group at 2 (MM: = .0009; knee joint: = .0160) and 8 (MM: = .0399; knee joint: = .0001) weeks. The IL-6 level was significantly lower in the sham-ESWT group than in the ESWT group at 2 (knee joint: = .0184) and 4 (knee joint: = .0247) weeks but higher at 8 weeks (MM: = .0169; knee joint: = .0038). The sham group had significantly higher osteoarthritis scores than the ESWT group at 4 (tibial plateau: = .0157) and 8 (femur: = .0048; tibial plateau: = .0359) weeks.
A single dose of radial ESWT promoted meniscal tear healing in the avascular zone, modulated inflammatory factors in the menisci and knee joints in rats, and alleviated cartilage degeneration.
Radial ESWT can be considered a potential option for improving meniscal tear healing in the avascular zone because of its ability to modulate inflammation.
体外冲击波疗法（ESWT）通过调节炎症促进组织愈合，这对无血管区半月板撕裂的愈合具有重要意义。
评估单次径向ESWT对无血管区半月板撕裂后半月板及膝关节愈合过程和炎症的影响。
对照实验室研究。
在72只Sprague-Dawley大鼠的内侧半月板（MM）上诱导无血管撕裂。术后1周，大鼠接受单次使用Power+手持探头的径向ESWT治疗（ESWT组；n = 36）或使用假探头治疗（假ESWT组；n = 36）。然后在术后2、4或8周对大鼠实施安乐死。采集MM进行愈合分析（苏木精-伊红染色、番红O-固绿染色和Ⅱ型胶原染色）和炎症分析（白细胞介素[IL]-1β和IL-6染色）。获取外侧半月板和滑膜以评估膝关节炎症（IL-1β和IL-6的酶联免疫吸附测定）。使用番红O-固绿染色评估股骨和胫骨平台的软骨退变情况。
术后4周（P = 0.0066）和8周（P = 0.0050），ESWT组的半月板愈合评分显著高于假ESWT组。术后2周（MM：P = 0.0009；膝关节：P = 0.0160）和8周（MM：P = 0.0399；膝关节：P = 0.0001），假ESWT组中的IL-1β水平显著高于ESWT组。术后2周（膝关节：P = 0.0184）和4周（膝关节：P = 0.0247），假ESWT组中的IL-6水平显著低于ESWT组，但在8周时更高（MM：P = 0.0169；膝关节：P = 0.0038）。术后4周（胫骨平台：P = 0.0157）和8周（股骨：P = 0.0048；胫骨平台：P = 0.0359），假ESWT组的骨关节炎评分显著高于ESWT组。
单次径向ESWT促进了无血管区半月板撕裂的愈合，调节了大鼠半月板和膝关节中的炎症因子，并减轻了软骨退变。
由于径向ESWT具有调节炎症的能力，可被视为改善无血管区半月板撕裂愈合的潜在选择。
