使用TENEX®经皮超声引导肌腱切开术的肌腱修复:牛尸体模型的组织学和宏观分析

Suwannika Palee , Chuanyong Lu , Adam Betcher , Ugur Yener , Jonathan Alerte , David Howarth , Luke Cooper , Asude Nur Hasanoglu , Alaa Abd-Elsayed , Sayed Emal Wahezi
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引用次数: 0

摘要

背景:慢性肌腱病的治疗仍然难以捉摸;然而,使用TENEX®(PUTT)的经皮超声引导肌腱切开术已显示出良好的临床效果,但其作用机制尚不明确。本研究旨在利用离体动物模型描述潜在的机制。该研究的目的是检查PUTT对牛比目鱼肌腱的组织学影响,跨越不同的治疗时间。方法将12只牛比目鱼肌腱分为4组,分别进行1、3、5和7分钟的PUTT治疗。每个标本在一侧治疗,另一侧作为对照。进行了宏观和微观分析,以评估肌腱鞘、肌腱束和神经周围的损伤。使用ImageJ软件测量束束穿透性。采用方差分析(ANOVA)进行统计分析,显著性水平设为p <;0.05.结果显微镜和显微镜检查显示,随着治疗时间的延长,肌腱束、腱束周围神经和肌腱束逐渐分离。在1、3、5和7 min时,束膜穿透深度分别为0.1 mm、2.57 mm、2.61 mm和3.93 mm。方差分析证实各组间存在显著差异(F (3,8) = 620.898, p <;0.001),效应值较大(η2 = 0.996)。Tukey的诚实显著差异(HSD)测试显示,大多数组之间存在显著差异(p <;0.001),除3 min与5 min处理间差异无统计学意义(p = 0.969)。结论putt可引起大鼠对腱膜和肌束层结构改变,且治疗时间越长,改变越明显。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tendon modification with percutaneous Ultrasound-Guided Tenotomy using TENEX®: A histological and macroscopic analysis of a bovine cadaveric model

Background

Chronic tendinopathy treatment remains elusive; however, percutaneous Ultrasound-Guided Tenotomy using TENEX® (PUTT) has demonstrated promising clinical outcomes, but the mechanism of action is not clearly defined. This study aims to describe potential mechanisms using an ex-vivo animal model. The objective of the study is to examine the histological effects of PUTT on the bovine soleus tendon across varying treatment durations.

Methods

Twelve bovine soleus tendons were allocated to four cohorts to undergo PUTT for 1, 3, 5, and 7 min. Each specimen was treated on one side, the opposite side serving as a control. Macroscopic and microscopic analyses were conducted to assess tendon sheath, fascicle, and perineural disruption. Fascicle penetration was measured using ImageJ software. Statistical analyses were performed using Analysis of Variance (ANOVA), with significance levels set at p < 0.05.

Results

Macroscopic and microscopic examination revealed progressive separation of the paratenon, peritendinous nerves, and fascicles, correlating with increased treatment duration. Fascicle penetration depths were 0.1 mm, 2.57 mm, 2.61 mm, and 3.93 mm at 1, 3, 5, and 7 min, respectively. ANOVA confirmed significant differences among groups (F (3, 8) = 620.898, p < 0.001), with a large effect size (η2 = 0.996. Tukey's Honest Significant Difference (HSD) test revealed significant differences between most groups (p < 0.001), except between the 3-min and 5-min treatments, which showed no significant difference (p = 0.969).

Conclusion

PUTT induces significant structural changes in the paratenon and fascicle layer with longer treatment duration, resulting in more pronounced modifications.
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