High-frequency ultrasound in the assessment of tendon injury and repair: study protocol for a self-controlled animal trial / 中国组织工程研究

ABSTRACT

BACKGROUND: Tendon injury is common in clinic, which is mainly treated by surgical anastomosis. Postoperative tendon healing is usually assessed through surgeons' experience due to high cost and application restrictions of MRI examination. Thus there is still a lack of a convenient and objective imaging support. With the advancement and widespread application of high-frequency ultrasound, the diagnosis rate of tendon injury has been improved remarkably; thereafter, high-frequency ultrasound used for assessing tendon injury and repair has become an issuehas become an issue of concern.OBJECTIVE: To clarify the ultrasonic imaging features of tendon repair through high-frequency ultrasound scancombined with histological examination.METHODS: This was a single-central, preoperative and self-controlled animal experiment and finished in the Central People'sHospital of Siping, China. 130 adult male Highbrow chickens were selected and were then randomized into 13 groups (n=10per group). One side of each chicken hind foot was randomly selected as experimental limb to undergo achillotomy followedby repair using the modified Kessler method (groups 2-13) or no treatment (group 1); the contralateral limb served as control.Moreover, passive flexion-extension functional training targeting the experimental limbs was performed in the groups 8-13beginning at the 1st day after surgical anastomosis, several times a day. The high-frequency ultrasound and hematoxylineosinstaining were conducted before and after chillotomy (group 1), and at 3 (groups 2 and 8), 7 (groups 3 and 9), 14 (groups4 and 10), 21 (groups 5 and 11), 35 (groups 6 and 12) and 42 (groups 7 and 13) days after surgical anastomosis, respectively.RESULTS AND CONCLUSION: The primary measurement outcomes were the repair and healing of the injured tendonas assessed by high-frequency ultrasound; the secondary outcomes were the pathological manifestations of the injuredtendon detected by hematoxylin-eosin staining. Our findings will provide preclinical proof for high-frequency ultrasounduse in the assessment of tendon injury, repair and healing as well as for the rehabilitation therapy that promotes functionrecovery in the future.