Background:Extracorporeal shock wave therapy (ESWT) promotes tissue healing by modulating inflammation, which has implications for meniscal tear healing in the avascular zone.Purpose:To evaluate the effects of a single dose of radial ESWT on the healing process and inflammation of the meniscus and knee joints after meniscal tears in the avascular zone.Study Design:Controlled laboratory study.Methods:Avascular tears were induced in the medial meniscus (MM) of 72 Sprague-Dawley rats. One week postoperatively, the rats received a single session of radial ESWT with a Power+ handpiece (ESWT group; n = 36) or with a fake handpiece (sham-ESWT group; n = 36). The rats were then euthanized at 2, 4, or 8 weeks postoperatively. The MMs were harvested for analysis of healing (hematoxylin-eosin, safranin O–Fast Green, and collagen type 2 staining) and inflammation (interleukin [IL]-1β and IL-6 staining). Lateral menisci and synovia were obtained to evaluate knee joint inflammation (enzyme-linked immunosorbent assay of IL-1β and IL-6). Cartilage degeneration was assessed in the femurs and tibial plateaus using safranin O–Fast Green staining.Results:The ESWT group showed significantly better meniscal healing scores than the sham-ESWT group at 4 ( P = .0066) and 8 ( P = .0050) weeks postoperatively. The IL-1β level was significantly higher in the sham-ESWT group than in the ESWT group at 2 (MM: P = .0009; knee joint: P = .0160) and 8 (MM: P = .0399; knee joint: P = .0001) weeks. The IL-6 level was significantly lower in the sham-ESWT group than in the ESWT group at 2 (knee joint: P = .0184) and 4 (knee joint: P = .0247) weeks but higher at 8 weeks (MM: P = .0169; knee joint: P = .0038). The sham group had significantly higher osteoarthritis scores than the ESWT group at 4 (tibial plateau: P = .0157) and 8 (femur: P = .0048; tibial plateau: P = .0359) weeks.Conclusion:A single dose of radial ESWT promoted meniscal tear healing in the avascular zone, modulated inflammatory factors in the menisci and knee joints in rats, and alleviated cartilage degeneration.Clinical Relevance:Radial ESWT can be considered a potential option for improving meniscal tear healing in the avascular zone because of its ability to modulate inflammation.

中文翻译：

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单剂量径向体外冲击波疗法可调节无血管区半月板撕裂愈合过程中的炎症

背景：体外冲击波疗法（ESWT）通过调节炎症促进组织愈合，这对无血管区的半月板撕裂愈合具有影响。目的：评估单剂量放射状 ESWT 对半月板愈合过程和炎症的影响研究设计：对照实验室研究。方法：在 72 只 Sprague-Dawley 大鼠的内侧半月板 (MM) 中诱导无血管撕裂。术后一周，大鼠接受一次使用 Power+ 手机（ESWT 组；n = 36）或假手机（假 ESWT 组；n = 36）的放射状 ESWT 治疗。然后在术后 2、4 或 8 周对大鼠实施安乐死。收获 MM 用于分析愈合（苏木精-伊红、番红 O-快绿和 2 型胶原染色）和炎症（白细胞介素 [IL]-1β 和 IL-6 染色）。获取外侧半月板和滑液来评估膝关节炎症（IL-1β和IL-6的酶联免疫吸附测定）。使用番红 O-快绿染色评估股骨和胫骨平台的软骨退变。结果：ESWT 组的半月板愈合评分明显优于假 ESWT 组，分别为 4 ( P = .0066) 和 8 ( P = .0050 ）术后几周。假 ESWT 组的 IL-1β 水平显着高于 ESWT 组，分别为 2（MM：P = .0009；膝关节：P = .0160）和 8（MM：P = .0399；膝关节： P = .0001) 周。假 ESWT 组的 IL-6 水平在第 2 周（膝关节：P = .0184）和第 4 周（膝关节：P = .0247）时显着低于 ESWT 组，但在第 8 周时更高（MM： P = .0169；膝关节：P = .0038)。在第 4 周（胫骨平台：P = .0157）和第 8 周（股骨：P = .0048；胫骨平台：P = .0359）时，假手术组的骨关节炎评分显着高于 ESWT 组。结论：单剂量桡骨ESWT 促进无血管区半月板撕裂愈合，调节大鼠半月板和膝关节的炎症因子，并减轻软骨变性。 临床相关性：径向 ESWT 可被认为是改善无血管区半月板撕裂愈合的潜在选择，因为其调节炎症的能力。