| Objective: To explore the effect of ultrasonic multimodal technique in evaluating the protection of cartilage by extracorporeal shock wave therapy (ESWT) combined with electrothermal acupuncture in knee osteoarthritis (KOA). Methods: A total of 43 healthy male SD rats with SPF grade were selected, 33 of which were used to establish KOA model. The 30 rats after successful modeling were divided into model control group, ESWT group, combined treatment group, 10 rats/group, and the rest 10 rats served as normal control group. Normal control group and model control group were not treated. The ESWT group received EWST intervention once a week for 3 consecutive weeks 24 h after modeling. The combined treatment group received ESWT combined with electrothermal acupuncture, and the intervention method of ESWT was the same as that of ESWT group, with electrothermal acupuncture once every other day, 20 min/ time, a total of 20 times. The degree of foot swelling and the threshold of plantar tenderness were detected before and after the intervention, and the ultrasonic elastic strain rate and peak time of knee joint were detected by ultrasonic multimodal technique. The levels of interleukin-6 (IL-6), IL-1β and tumor necrosis factor-α (TNF-α) in joint fluid were detected by enzyme-linked immunosorbent assay (ELISA), and the his-topathologic changes of knee joint were detected by hematoxylin-eosin (HE) staining. The expression levels of matrix metalloproteinase 3 (MMP-3) and MMP-9 in articular cartilage were detected by Western blotting. Results: Compared with the normal control group, the swelling degree of foot, the ultrasonic elastic strain rate, serum IL-6, IL-1β, TNF-α, MMP-3 and MMP-9 proteins were increased in the model group, and the pain threshold and time to peak were decreased (P<0.05). Compared with model group, foot swelling degree, ultrasonic elastic strain rate, serum IL-6, IL-1β, TNF-α, MMP-3 and MMP-9 proteins were decreased in ESWT group, and pain threshold and time to peak were increased (P<0.05). Compared with ESWT group, the degree of foot swelling, the ultrasonic elastic strain rate and IL-6, IL-1β, TNF-α, MMP-3 and MMP-9 proteins in joint fluid were decreased in combined group, and the pain threshold and time to peak were increased (P<0.05). HE staining showed that the cartilage structure of the normal control group was intact. In the model group, the cartilage injury and inflammatory infiltration were severe. The cartilage structure of rats in all treatment groups was improved, and the surface tended to be smooth, complete and clear, among which the improvement of the combined group was the most significant. Conclusion: ESWT combined with electrothermal acupuncture has a good effect in the treatment of knee osteoarthritis, and it is found that the combined treatment has a good effect on cartilage protection through ultrasonic multimodal technology. |
