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First published on May 11, 2005, doi:10.1177/0363546504267356
This version was published on July 1, 2005
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The American Journal of Sports Medicine 33:1048-1056 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

The Effects of Low-Intensity Ultrasound on Medial Collateral Ligament Healing in the Rabbit Model

Karen J. Sparrow, PT, PhD*,{dagger}, Sheryl D. Finucane, PT, PhD{dagger}, John R. Owen, PE{ddagger} and Jennifer S. Wayne, PhD{ddagger}

From the {dagger} Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, and the {ddagger} Orthopaedic Research Laboratory, Departments of Biomedical Engineering and Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia

* Address correspondence to Karen J. Sparrow, PT, PhD, Virginia Commonwealth University, Department of Physical Therapy, School of Allied Health, 1200 East Broad Street, PO Box 980224, Richmond, VA 23298-0224.

Background: Ruptured medial collateral ligaments are capable of healing over time, but biomechanical and biochemical properties remain inferior to normal tissue. Low-intensity ultrasound may improve healing.

Hypothesis: Medial collateral ligaments treated with ultrasound will demonstrate superior healing.

Study Design: Controlled laboratory study.

Methods: Twenty-one late-adolescent male rabbits underwent bilateral ligament transection. One ligament from each rabbit received ultrasound treatment every other day for 6 total treatments. Contralateral ligaments received sham treatments. After 3 or 6 weeks, ligaments were evaluated biomechanically and assayed for collagen concentration and the relative proportions of types I and III collagen.

Results: Areas of sonicated specimens were significantly larger (10.6% ± 4.90%) at 6 weeks. Ultimate load (39.5% ± 17.0%), ultimate displacement (24.5% ± 8.0%), and energy absorption (69.1% ± 22.0%) were significantly higher for sonicated specimens at 6 weeks. No significant biomechanical differences were observed at 3 weeks. The relative proportion of type I collagen was significantly higher in sonicated ligaments at 3 weeks (8.61% ± 4.0%) and 6 weeks (6.91% ± 3.0%). No significant differences in collagen concentration were observed at either 3 or 6 weeks.

Conclusion: Subtle improvement with ultrasound treatment may be apparent by 3 weeks after injury, suggested by increased proportion of type I collagen. Ultrasound appears to improve some structural properties and to modestly increase scar cross-sectional area and type I collagen present at 6 weeks after injury in this model.

Clinical Relevance: Ultrasound treatments after ligament injury may facilitate earlier return to activities and decrease risk of reinjury.

Key Words: therapeutic ultrasound • ligament healing • biomechanics • collagen • medial collateral ligament (MCL) • rabbit




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