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Percutaneous soft tissue release performed using a blunt cannula in rabbits with chronic collagenase-induced Achilles tendinopathy
Authors:Yueh-Ling Hsieh  Ming-Ta Lin  Chang-Zern Hong  Hsin-Shui Chen
Affiliation:1. Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan;2. Kuan-Ta Rehabilitation and Pain Clinic, Taichung 40652, Taiwan;3. Taiwan Myopain Society, Taichung 40402, Taiwan;4. Department of Physical Medicine and Rehabilitation, China Medical University, Bei-Gang Hospital, Yun-Lin 65152, Taiwan;5. Department of Rehabilitation Medicine, School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
Abstract:

Background

This study investigated the effects of percutaneous soft tissue release (PSTR) performed using a blunt cannula on (1) the inflammatory cells-count, (2) expressions of calcitonin gene-related peptide (CGRP) and (3) substance P (SP) in rabbits with chronic phase of collagenase-induced Achilles tendinopathy.

Methods

Thirty-two adult male New Zealand rabbits were randomly divided into four groups: (1) collagenase and PSTR treatment; (2) collagenase and sham-operated PSTR treatment; (3) vehicle-only injection and PSTR treatment; and (4) vehicle-only injection and sham-operated PSTR treatment. Achilles tendon of adult male rabbits was injected with 10 μl of collagenase under ultrasonography localization. After 30 days, PSTR was performed using an 18G beauty cosmetic blunt tip micro cannula needle to release the soft tissue and paratenon above the inflamed Achilles tendon. The treated tendons and spinal cords of L5-S2 were harvested 5 days after treatment for histological assessment and immunohistochemical analysis.

Results

Histopathological examination revealed that PSTR achieved significant reduction in hypercellularity with pronounced infiltration of immune cells at the site of paratenon in tendons injected with collagenase compared with sham operation (p < 0.05). Immunohistochemical analysis also showed marked decrease in expression of CGRP in tendon and SP in dorsal horns after PSTR (p < 0.05).

Conclusions

This study showed positive effects in an animal model of chronic tendinopathy, and can be considered a treatment option, but that further research is necessary to determine its role in clinical practice.
Keywords:Achilles tendon  Chronic tendinopathy  Percutaneous soft tissue release  Blunt cannula  Inflammation pain
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