Turkish Journal of Physical Medicine and Rehabilitation 2021 , Vol 67 , Num 2

Effects of low-density pulsed ultrasound treatment on transforming growth factor-beta, collagen level, histology, biomechanics, and function in repaired rat tendons

Alperen İnceoğlu 1 ,Füsun Şahin 2 ,Nuray Akkaya 2 ,Nusret Ök 3 ,Çağdaş Yörükoğlu 3 ,Gülçin Mete 4 ,Şakir Akgün 5
1 Department of Physical Medicine and Rehabilitation, Osmaniye State Hospital, Osmaniye, Turkey
2 Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey
3 Department of Orthopedics and Traumatology, Pamukkale University Faculty of Medicine, Denizli, Turkey
4 Department of Histology and Embryology, Pamukkale University Faculty of Medicine, Denizli, Turkey
5 ILTAM Laboratory, Pamukkale University Faculty of Medicine, Denizli, Turkey
DOI : 10.5606/tftrd.2021.5118 Objectives: The aim of this study is to compare the effects of low-density pulsed ultrasound (LIPUS) treatment on growth factors/collagen production, histological, biomechanical, and function of rats with Achilles tendon injury.

Materials and methods: A total of 44 Wistar Albino rats were used in the study between April 2017 and June 2018. The rats were randomized to two treatment groups. Group 1 (n=6) received LIPUS treatment (0.3 Watt/cm2; 1 MHz, 1:5 pulse mode) and Group 2 (n=6)received sham ultrasound (US) treatment following Achilles tendon surgery. Transforming growth factor-beta 1 (TGF-β1) and collagen gene expression levels were evaluated using polymerase chain reaction. The histological evaluation was performed with the Bonar scoring system. The tensile strength was measured by biomechanical testing and the function was evaluated with the Achilles Functional Index (AFI).

Results: Although TGF-β1 expression and tensile strength evaluation showed a tendency to improve in favor of the LIPUS group, no statistically significant difference was found (p=0.065 and p=0.053, respectively). The COL3 gene expression in the LIPUS group and the COL1 expression in the sham US group were significantly higher. Bonar scores and AFI scores showed a statistically significant improvement in the LIPUS group, compared to the sham US group.

Conclusion: Our study results show that LIPUS yields positive effects on tendon histology and functional status in repaired Achilles tendon in rats. Keywords : Achilles tendon, biomechanic, growth factor, histology, low-density therapeutic ultrasound, tendon injury