Low intensity pulsed ultrasound increases the mechanical properties of the healing tissues at bone-tendon junction

The re-establishment of bone-tendon junction (BTJ) tissues is involved in many trauma and reconstructive surgeries. A direct BTJ repair requires a long period of immobilization which may be associated with a postoperative weak knee. In this study, we investigated if low-intensity pulsed ultrasound treatment increases the material properties of healing tissues at bone-tendon junction (BTJ) after partial patellectomy using rabbit models. Standard partial patellectomy was conducted on one knee of twenty four rabbits which were randomly divided into an ultrasound group and a control group. The bony changes of BTJ complexes around the BTJ healing interface were measured by anteroposterior X-ray radiographs; then the volumetric bone-mineral density (BMD) of the new bone was assessed using a peripheral computed tomography scanner (pQCT). The stiffness of patellar cartilage, fibrocartilage at the healing interface and the tendon were measured in situ using a novel noncontact ultrasound water jet indentation system. Not only significantly more newly formed bone at the BTJ healing interface but also increased stiffness of the junction tissues were found in the ultrasound group compared with the controls at week 18. In addition, the ultrasound group also showed significantly 44% higher BMD at week 6 than controls.