Evaluation of Bone-Tendon Junction Healing Using Water Jet Ultrasound Indentation Method

Abstract

26The re-establishment of bone-tendon junction (BTJ) tissues with the junction, 27 characterized as a unique transitional fibrocartilage zone, is involved in many trauma and 28 reconstructive surgeries. Experimental and clinical findings have shown that a direct BTJ 29 repair requires a long period of immobilization which may be associated with a 30 postoperative weak knee. Therefore, it's very necessary to evaluate the morphological 31 and mechanical properties of BTJ tissues in situ to better understand the healing process 32 for the purpose of reducing the adverse effects of immobilization. We previously reported 33 a noncontact ultrasound water jet indentation system for measuring and mapping tissue 34 mechanical properties. The key idea was to utilize a water jet as an indenter as well as the 35 coupling medium for high-frequency ultrasound. In this paper, we used the ultrasound 36 water jet indentation to evaluate the BTJ healing process. The system's capability of 37 measuring the material elastic modulus was first validated using tissue-mimicking 38 phantoms. Then it was employed to assess the healing of the BTJ tissues after partial 39 patellectomy over time on twelve 18-week-old female New Zealand White rabbits. It was 40 found that, in comparison with the normal control samples, the elastic modulus of the 41 fibrocartilage of the postoperative samples was significantly smaller, while its thickness 42 increased significantly. Among the postoperative sample groups, the elastic modulus of 43 the fibrocartilage of the samples harvested at week 18 was significantly higher than those 44 harvested at week 6 and week 12, which was even comparable with the value of the 45 control samples at the same sacrificed time. The results suggested that the noncontact 46 ultrasound water jet indentation system provided a nondestructive way to evaluate the 47 3 material properties of small animal tissues in situ, thus had the ability to evaluate the 48 healing process of BTJ. 49 50

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