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Khandare S, Smallcomb M, Elliott J, Vidt ME, Simon JC. Focused ultrasound as an alternative to dry needling for the treatment of tendinopathies: A murine model. J Orthop Res 2024; 42:598-606. [PMID: 37804211 PMCID: PMC10932869 DOI: 10.1002/jor.25700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 05/26/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023]
Abstract
Tendinopathies account for 30% of 102 million annual musculoskeletal injuries occurring annually in the United States. Current treatments, like dry needling, induce microdamage to promote healing but produce mixed success rates. Previously, we showed focused ultrasound can noninvasively create microdamage while preserving mechanical properties in ex vivo murine tendons. This present study compared growth factor, histological, and mechanical effects after focused ultrasound or dry needling treatments in an in vivo murine tendon injury model. Partial Achilles tenotomy was performed in 26 rats. One-week postsurgery, tendons were treated with focused ultrasound (1.5 MHz, 1-ms pulses at 10 Hz for 106 s, p+ = 49 MPa, p- = 19 MPa) or dry needling (30 G needle, 5 fenestrations over 20 s) and survived for 1 additional week. Blood was collected immediately before and after treatment and before euthanasia; plasma was assayed for growth factors. Treated tendons and contralateral controls were harvested for histology or mechanical testing. No differences were found between treatments in release of insulin growth factor 1 and transforming growth factor beta; vascular endothelial growth factor A concentrations were too low for detection. Histologically, focused ultrasound and dry needling tendons displayed localized fibroblast infiltration without collagen proliferation with no detectable differences between treatments. Mechanically, stiffness and percent relaxation of dry needling tendons were lower than controls (p = 0.0041, p = 0.0441, respectively), whereas stiffness and percent relaxation of focused ultrasound tendons were not different from controls. These results suggest focused ultrasound should be studied further to determine how this modality can be leveraged as a therapy for tendinopathies.
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Affiliation(s)
- Sujata Khandare
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
| | - Molly Smallcomb
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA USA
| | - Jacob Elliott
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA USA
| | - Meghan E. Vidt
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
- Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Julianna C. Simon
- Biomedical Engineering, Pennsylvania State University, University Park, PA, USA
- Graduate Program in Acoustics, Pennsylvania State University, University Park, PA USA
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Arrizabalaga JH, Smallcomb M, Abu-Laban M, Liu Y, Yeingst TJ, Dhawan A, Simon JC, Hayes DJ. Ultrasound-Responsive Hydrogels for On-Demand Protein Release. ACS APPLIED BIO MATERIALS 2022; 5:3212-3218. [PMID: 35700312 PMCID: PMC10496416 DOI: 10.1021/acsabm.2c00192] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of tunable, ultrasound-responsive hydrogels that can deliver protein payload on-demand when exposed to focused ultrasound is described in this study. Reversible Diels-Alder linkers, which undergo a retro reaction when stimulated with ultrasound, were used to cross-link chitosan hydrogels with entrapped FITC-BSA as a model protein therapeutic payload. Two Diels-Alder linkage compositions with large differences in the reverse reaction energy barriers were compared to explore the influence of linker composition on ultrasound response. Selected physicochemical properties of the hydrogel construct, its basic degradation kinetics, and its cytocompatibility were measured with respect to Diels-Alder linkage composition. Focused ultrasound initiated the retro Diels-Alder reaction, controlling the release of the entrapped payload while also allowing for real-time visualization of the ongoing process. Additionally, increasing the focused ultrasound amplitude and time correlated with an increased rate of protein release, indicating stimuli responsive control.
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Affiliation(s)
- Julien H Arrizabalaga
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Molly Smallcomb
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Mohammad Abu-Laban
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Yiming Liu
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Tyus J Yeingst
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Aman Dhawan
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, United States
| | - Julianna C Simon
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Daniel J Hayes
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- Materials Research Institute, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
- The Huck Institute of the Life Sciences, Millennium Science Complex, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
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