Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (30): 4775-4780.doi: 10.3969/j.issn.2095-4344.2017.30.004

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Low-intensity pulsed ultrasound combined with intra-articular injection of sodium hyaluronate in the repair of articular cartilage defects

Hao De-feng, Zhang Lu-qing, Liu Yu-dong
  

  1. Department of Ultrasound, Weifang Yidu Central Hospital, Weifang 262500, Shandong Province, China
  • Received:2017-08-07 Online:2017-10-28 Published:2017-11-07
  • About author:Hao De-feng, Attending physician, Department of Ultrasound, Weifang Yidu Central Hospital, Weifang 262500, Shandong Province, China
  • Supported by:
     the Funded Project of Shandong Provincial Health Department, No. 2015HZ026

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Abstract:

BACKGROUND: As reported, the use of low-intensity pulsed ultrasound combined with intra-articular injection of sodium hyaluronate in rabbit articular cartilage defect repair is ideal, which can promote the healing of defect site. However, the conclusion has not been further confirmed.
OBJECTIVE: To investigate the effect of low-intensity pulsed ultrasound combined with intra-articular injection of sodium hyaluronate in repairing articular cartilage defects in rabbits.
METHODS: Sixty rabbits were anesthetized using 20% urethane solution injection at a dose of 4mL/kg, and a model of articular cartilage defect (3 mm in diameter and 3 mm in depth) was made on the femoral ankle of each rabbit. Then, there were three groups in this study: model group with no intervention, sodium hyaluronate group with intra-articular injection of sodium hyaluronate, and observation group with intra-articular injection of sodium hyaluronate combined with low-intensity pulsed ultrasound. Gross observation, hematoxylin-eosin staining, safranin O staining and Wakitani scores were compared among groups after repair.
RESULTS AND CONCLUSION: (1) At 5 weeks after repair, in the model group, the defect size was reduced with uneven surface that was lower than the surrounding tissues; in the sodium hyaluronate group, there was a clear boundary between the defect and surrounding cartilage tissues; in the observation group, the defect was completely repaired. (2) After 2 and 5 weeks, the Wakitani scores in the observation group were significantly lower than those in the other two groups (P < 0.05). (3) After 5 weeks, in the observation group, the cells around the defect site arranged regularly, and in the sodium hyaluronate group, there were a large amount of cartilage-like cells in few cartilage regions. In the model group, there were irregularly arranged capillary blood vessels after 2 and 5 weeks. (4) After 5 weeks of repair, cartilage tissues with normal structure were found in the defect site in the observation group, and deeply stained proteoglycan and cartilage lacunae were observed in the sodium hyaluronate group, while in the model group, the deep layer stained white was observed at 2 and 5 weeks after repair. To conclude, low-intensity pulsed ultrasound combined with intra-articular injection of sodium hyaluronate can achieve the ideal repair effect on rabbit articular cartilage defects.

Key words: Sonication, Cartilage, Articular, Hyaluronic Acid, Tissue Engineering

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