Comparison between dry needling and focused ultrasound on the mechanical properties of the rat Achilles tendon: A pilot study

Khandare, Sujata; Smallcomb, Molly; Klein, Bailey; Geary, Colby; Simon, Julianna C.; Vidt, Meghan E.

doi:10.1016/j.jbiomech.2021.110384

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…It is theorized that the inflammatory reaction causes an increase in blood flow through local vasodilatation, granulation tissue production, collagen proliferation, and tendon strengthening. Dry needling, however, lacks significant concentrations of growth factors to speed up the repair of damaged tissue [13][14][15]. Medical imaging is the gold standard for diagnosing tendinopathy [16].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report

Shahbazi

2023

Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin

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Background Patellar tendinitis is common in jumping sports. Pain from patellar tendinopathy is challenging to manage. Dry needling as a stand-alone treatment for tendinopathy is supported. To our knowledge, dry needling has never been used alone. This case report depicts dry needling on the proximal patellar pole. Case description A 43-year-old male presented with left suprapatellar tendinitis. He was injured four months before beginning dry needling while playing futsal without warming up. The superior pole of the patellar was tender to palpation and caused moderate pain. At 20 degrees of knee flexion, discomfort began during double leg squats. The Clarke’s Sign, Eccentric Step, and Step Up tests showed positive results. The patient received five sessions of DN at the proximal pole of the patella twice weekly. This study’s primary outcomes were the numeric pain rating scale (NPRS), the Kujala Anterior Knee Pain Scale (AKPS), the global rating of change scale (GRC), and the angle of knee flexion during the squat. The researcher collected data at the five stages. Outcomes The patient’s primary outcome measures improved after three weeks of DN and three months of follow-up. The NPRS showed a reduction in pain, while the AKPS demonstrated a decrease in disability. Conclusion The successful treatment of a patient with suprapatellar tendinopathy utilizing DN is possibly described for the first time in this case report. This study demonstrated the efficacy of dry needling as a first-line treatment for managing chronic tendinopathy with a history of trauma.

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Section: Discussionmentioning

confidence: 99%

The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report

Shahbazi

2023

Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin

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“…For DN, a 30G acupuncture needle (311.2 μm diameter) was inserted and quickly removed from tendon midbody five times over 12-20 s. 19,22 For fUS, a spherically curved single-element fUS transducer of 1.5 MHz operating frequency and f-number of 0.7 (H-234 modified with 42-mm central opening; Sonic Concepts) and linear radiofrequency power amplifier (55 dB, 1040 L; Electronics & Innovations Ltd.) were used to deliver 1 ms pulses at 10 Hz for 106 s with peak positive and negative pressures of 49 and 19 MPa, respectively, while the rat was partially submerged in a degassed, deionized water tank (Figure 1). These parameters were based on our previous ex vivo parameter exploration studies.…”

Section: Dn and Fus Treatmentmentioning

confidence: 99%

“…16 Focused ultrasound (fUS) is a promising, noninvasive, clinically adopted treatment modality that focuses acoustic energy within a well-defined focal volume to create thermal and/or mechanical bioeffects without damaging the intervening tissue. 17,18 Our previous ex vivo studies [19][20][21][22] explored a range of fUS parameters on ex vivo murine tendons and compared the histological and mechanical effects to DN. Smallcomb et al 20 found that mild mechanical disruption, or nonthermal microdamage in the form of localized fiber separation and/or fiber pattern disruption, was achievable histologically in ex vivo tendons for a small window of fUS acoustic parameters.…”

Section: Introductionmentioning

confidence: 99%

“…Smallcomb et al 20 found that mild mechanical disruption, or nonthermal microdamage in the form of localized fiber separation and/or fiber pattern disruption, was achievable histologically in ex vivo tendons for a small window of fUS acoustic parameters. Results of Khandare et al 19,22 further investigated these acoustic parameters through mechanical testing, and identified one set of fUS parameters that preserved tendon mechanical properties better than DN. However, it is unknown whether fUS microdamage can initiate a healing response in injured tendon.…”

Section: Introductionmentioning

confidence: 99%

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Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model

Khandare,

Smallcomb,

Elliott

et al. 2023

Journal Orthopaedic Research

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Tendinopathies account for 30% of 102 million annual musculoskeletal injuries occurring annually in the United States. Current treatments, like dry needling, induce microdamage to promote healing but produce mixed success rates. Previously, we showed focused ultrasound can noninvasively create microdamage while preserving mechanical properties in ex vivo murine tendons. This present study compared growth factor, histological, and mechanical effects after focused ultrasound or dry needling treatments in an in vivo murine tendon injury model. Partial Achilles tenotomy was performed in 26 rats. One‐week postsurgery, tendons were treated with focused ultrasound (1.5 MHz, 1‐ms pulses at 10 Hz for 106 s, p+ = 49 MPa, p− = 19 MPa) or dry needling (30 G needle, 5 fenestrations over 20 s) and survived for 1 additional week. Blood was collected immediately before and after treatment and before euthanasia; plasma was assayed for growth factors. Treated tendons and contralateral controls were harvested for histology or mechanical testing. No differences were found between treatments in release of insulin growth factor 1 and transforming growth factor beta; vascular endothelial growth factor A concentrations were too low for detection. Histologically, focused ultrasound and dry needling tendons displayed localized fibroblast infiltration without collagen proliferation with no detectable differences between treatments. Mechanically, stiffness and percent relaxation of dry needling tendons were lower than controls (p = 0.0041, p = 0.0441, respectively), whereas stiffness and percent relaxation of focused ultrasound tendons were not different from controls. These results suggest focused ultrasound should be studied further to determine how this modality can be leveraged as a therapy for tendinopathies.

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“…Khandare et al reported that the Young's modulus did not change, but the stiffness decreased, in the Achilles tendon of rats irradiated with HIFU. Using tissue staining, they concluded that this change was caused by thermal changes [20]. Thus, HIFU has been shown to decrease the mechanical strength of fibrous tissue.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Changes in Fibrous Tissue Exposed to Non‐Convergent Ultrasound

Yagi

KOIKE

Uchida

2023

IEEJ Transactions Elec Engng

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Fibrosis is a disease that involves an abnormal accumulation of extracellular matrix material such as collagen, leading to organ failure. This type of organ failure accounts for around one‐third of all deaths worldwide. However, since there are no drugs which are curative for this disease, the development of non‐invasive treatment strategies is important. In this study, we developed a method of softening fibrotic tissue using non‐converging ultrasound irradiation, a non‐thermal treatment. The generation of cavitation in a standing wave caused the mechanical strength of the fibrotic tissue to decrease in an irradiation time‐dependent manner. The appearance of the fibrous tissue also changed after irradiation, possibly due to the fracture of collagen fibers by ultrasonic cavitation. This method has the potential to treat a wide range of fibrotic tissues. © 2023 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC.

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Comparison between dry needling and focused ultrasound on the mechanical properties of the rat Achilles tendon: A pilot study

Cited by 9 publications

References 26 publications

The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report

The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report

Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model

Mechanical Changes in Fibrous Tissue Exposed to Non‐Convergent Ultrasound

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