SWE评估针刀松解法对膝骨关节炎模型兔MCL、LCL弹性模量的影响

目的:观察针刀干预腘绳肌对KOA模型兔膝关节内外侧副韧带超声弹性模量的变化,探讨针刀松解法对内外侧副韧带力学性能的影响。方法:6月龄新西兰雄兔28只,随机数字表法分为正常组、模型组、针刀组、电针组共4组,每组7只。采用改良Videman左后肢伸直位固定法制备KOA模型,制动8周。电针组取穴“曲泉”“委阳”“内膝眼”“外膝眼”,隔天治疗1次,针刀组干预腘绳肌,每周治疗1次,两组各干预3周。采用HE染色光镜观察内外侧副韧带的形态变化、实时剪切波超声弹性成像技术量化评估内外侧副韧带的超声弹性模量。结果:MCL超声弹性模量比较:对比正常组,模型组MCL超声弹性模量降低,差异具有统计学意义(P<0.05);对比模型组,针刀组、电针组MCL超声弹性模量上升,差异无统计学意义(P>0.05);对比电针组,针刀组MCL超声弹性模量上升,差异无统计学意义(P>0.05),但上升趋势更接近正常组。LCL超声弹性模量比较:对比正常组,模型组LCL超声弹性模量降低,差异具有统计学意义(P<0.05);对比模型组,针刀组、电针组LCL超声弹性模量上升,差异具有统计学意义(P<0.05);对比电针组,针刀组LCL超声弹性模量上升,差异无统计学意义(P>0.05),但上升趋势更接近正常组。结论:针刀干预腘绳肌可提高KOA兔膝关节内外侧副韧带的超声弹性模量,改善KOA兔内外侧副韧带的力学性能。

Effect of Acupotomy Loosening Therapy on the Elastic Modulus of MCL and LCL in Rabbit Models of KOA Evaluated by SWE

Objective:To observe the changes of ultrasonic elastic modulus of medial and lateral collateral ligaments of knee joint in knee osteoarthritis(KOA)model rabbits after acupotomy intervention on hamstring muscles,and to explore the influence of acupotomy loosening therapy on the biomechanical property of medial and lateral collateral ligaments(MCL and LCL).Methods:28 male New Zealand rabbits aged six months were randomly divided into the blank group,the model group,the acupotomy group and the electro-acupuncture group,with 7 rabbits in each group.The KOA model was established by modified Videman method of left hind leg unbent fixed and immobilized for 8 weeks.Points chosen in the electro-acupuncture group were Ququan(LR8),Weiyang(BL39),Neixiyan(Ex-LE5)and Dubi(ST35),and the electro-acupuncture was once every other day.Hamstring muscles were intervened with acupotomy once a week in the acupotomy group.Both groups were treated for three weeks.Morphological changes of the MCL and LCL were observed by HE staining light microscope and the ultrasonic elastic modulus of the MCL and LCL were quantitatively evaluated by real-time shear wave ultrasound elastography(SWE).Results:In terms of the elastic modulus of MCL ultrasound,it was reduced in the model group compared to that in the blank group;compared to the model group,it was increased in the acupotomy group and in the electro-acupuncture group,which showed no statistical significant differences(P>0.05);it was higher in the acupotomy group compared to that in the electro-acupuncture group,which also showed no statistical significant differences(P>0.05),however the upward trend was closer to the normal group.In terms of the ultrasonic elastic modulus of the LCL,it was decreased in the model group compared to that in the blank group(P<0.05);it was significantly increased in the electro-acupuncture group and in the acupotomy group compared to that in the model group(P<0.05);it was higher in the acupo-tomy group compared to that in the electro-acupuncture group,which shows no statistical significant differences in the two group(P>0.05),but the upward trend was closer to the normal group.Conclusion:Acupotomy intervention on hamstring muscles can improve the ultrasonic elastic modulus of the MCL and LCL of the knee in KOA rabbits,and it can improve the biomechanical property of the MCL and LCL in KOA rabbits.