Treatment of post-traumatic joint contracture in a rabbit model using pulsed, high intensity laser and ultrasound.
Treatment of post-traumatic joint contracture in a rabbit model using pulsed, high intensity laser and ultrasound.
复制标题
使用脉冲、高强度激光和超声波治疗兔模型创伤后关节挛缩。
DOI：
10.1088/1361-6560/aadff0
复制
发表时间：
2018
影响因子：
3.5
通讯作者：
Yang,Xinmai
中科院分区：
文献类型：
--
作者：
Hazlewood,David;Feng,Yi;Lu,Qinghua;Wang,Jinxi;Yang,Xinmai
手术或损伤后瘢痕组织引起的创伤后关节挛缩可使患者处于永久性疼痛和残疾状态，目前的治疗方法难以解决。本随机对照试验探讨了脉冲高强度激光（PHIL）和脉冲高强度聚焦超声（PHIFU）治疗由关节纤维化引起的创伤后关节挛缩的疗效。PHIL和PHIFU的峰值功率水平都远远高于目前物理治疗中使用的激光或超声，同时使用短脉冲来防止损伤。为了验证这些治疗方法的有效性，我们建立了兔膝关节关节挛缩模型。21只家兔分为4组：未处理对照组（n= 5）、PHIL组（n= 5）、PHIFU组（n= 5）和PHIL+ PHIFU组（n= 6）。在16周的时间里，将手术改良兔膝关节的最大伸度与对侧对照膝关节的最大伸度进行比较。未治疗对照组的兔子保持相对一致的关节挛缩水平，而每个治疗组的每只兔子的活动范围都有所改善，最终导致正常的关节伸展恢复。PHIL治疗组平均恢复时间7.6±1.5周，PHIFU治疗组平均恢复时间9.8±3.7周，联合治疗组平均恢复时间8.0±2.2周。组织病理学显示治疗后膝关节瘢痕组织密度降低，吸收加速。本研究证明了PHIL和PHIFU治疗家兔创伤后关节挛缩的有效性，并为进一步研究PHIL和PHIFU治疗的潜在机制提供了依据。
Post-traumatic joint contracture induced by scar tissues following a surgery or injury can leave patients in a permanent state of pain and disability, which is difficult to resolve by current treatments. This randomized controlled trial examines the therapeutic effect of pulsed high-intensity laser (PHIL) and pulsed high-intensity focused ultrasound (PHIFU) for post-traumatic joint contracture due to arthrofibrosis. The peak power levels of both PHIL and PHIFU are much higher than that of laser or ultrasound currently used in physical therapy, while short pulses are utilized to prevent damage. To test the effectiveness of these treatments, a rabbit knee model for joint contracture was established. Twenty-one rabbits were split into four groups: untreated control (n= 5), PHIL (n= 5), PHIFU (n= 5), and a PHIL+ PHIFU group (n= 6). Maximum extension of the surgically modified rabbit knee was compared to that of the contralateral control knee over the course of 16 weeks. The rabbits in the untreated control group maintained a relatively consistent level of joint contracture, while every rabbit in each of the treatment groups had improved range of motion, eventually leading to a restoration of normal joint extension. Average recovery time was 7.6±1.5 weeks for the PHIL treatment group, 9.8±3.7 weeks for the PHIFU group, and 8.0±2.2 weeks for the combined treatment group. Histopathology demonstrated reduced density and accelerated resorption of scar tissues in the treated knee joints. This study provides evidence that both PHIL and PHIFU are effective in treating post-traumatic joint contracture in rabbits and warrant further investigation into the underlying mechanisms to optimize PHIL and PHIFU based treatments in a larger number of animals.