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Histotripsy in collagenous tendons.

Molly Smallcomb1, Julianna C Simon1

  • 1Department of Acoustics, Pennsylvania State University, University Park, PA, 16802.

Proceedings of Meetings on Acoustics. Acoustical Society of America
|July 28, 2021
PubMed
Summary

High-intensity focused ultrasound (HIFU) aims to fractionate tendons, but collagenous tissues resist this method. Researchers explored acoustic parameters, achieving bubble creation but limited tendon damage, suggesting a need for stronger bubble collapse.

Area of Science:

  • Biomedical Engineering
  • Musculoskeletal Research
  • Ultrasound Technology

Background:

  • Tendon injuries are prevalent, leading to significant healthcare costs.
  • Current conservative therapies for tendon injuries have variable success rates.
  • Histotripsy, a focused ultrasound technique, struggles to fractionate highly collagenous tissues like tendons.

Purpose of the Study:

  • To investigate acoustic parameters for effective mechanical fractionation of tendons using histotripsy.
  • To determine if specific ultrasound parameters can overcome tendon's resistance to histotripsy.
  • To explore the feasibility of using bubble dynamics for tendon tissue modification.

Main Methods:

  • Large animal Achilles tendons were exposed to high-intensity focused ultrasound (HIFU) with varying frequencies, pulse durations, repetition rates, and acoustic pressures.

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  • Bubble activity within the focal zone was monitored using an ultrasound imaging system.
  • Tendon samples underwent histological analysis (H&E staining) and enzymatic activity assessment (αNADH-d staining).

    • Main Results:

    • Bubble generation was confirmed in the focal region of the exposed tendons.
    • Despite successful bubble formation, only one out of ninety samples exhibited focal coagulative necrosis.
    • Histological and enzymatic analyses indicated minimal tissue damage under the tested conditions.

    Conclusions:

    • Achieving mechanical fractionation of tendons with histotripsy remains challenging due to tissue resistance.
    • The size or collapse strength of the generated bubbles may be insufficient for effective tendon fractionation.
    • Further research is needed to optimize acoustic parameters for successful tendon treatment with histotripsy.