Failure of the tendon or ligament insertions is one of the most common injuries in the Orthopaedic field. To elucidate the pathogenesis of those injuries, the authors had attempted to measure the tissue sound speed that could be correlated to its elasticity using scanning acoustic microscopy (SAM). For the application of SAM to tendon or ligament insertions, it was necessary to determine the role of decalcification in SAM measurements since mineralized tissues including bone or mineralized fibrocartilage were present at the insertion site. To assess whether decalcification alters the tissue sound speed or not, supraspinatus tendon insertion of six Japanese white rabbits were measured with SAM operating in the frequency range of 50-150 MHz. Right supraspinatus tendons attached to the humeral head were cut into two pieces at the center of the tendon. Then, they were fixed with 10% neutralized formalin for 12 h. In each specimen, medial half was not decalcified, while lateral half was decalcified with ethylene-diamine-tetra-acetic acid (EDTA). After embedding in paraffin, 5 μm thick specimens were prepared for the measurement using SAM. The mean sound speed in each histologic zone was evaluated, and subsequently compared to that measured in the undecalcified and the decalcified specimens. Mean sound speed of non-mineralized fibrocartilage was 1544 m/s in the undecalcified specimens, while the value of 1541 m/s was determined in the decalcified ones. On the other hand, it decreased 2-3% after decalcification in the mineralized tissue including mineralized fibrocartilage and bone (mineralized fibrocartilage: undecalcified = 1648 m/s, decalcified = 1604 m/s; bone: undecalcified = 1716 m/s, decalcified = 1677 m/s). However, no significant differences were found between the undecalcified and the decalcified specimens (non-mineralized fibrocartilage: p = 0.84, mineralized fibrocartilage: p = 0.35, bone: p = 0.28). These results indicate that SAM could be applied to determine the properties of the tendon or the ligament insertions after decalcification with EDTA. Although SAM is applicable only for in vitro experimental study, it is expected that these data will contribute to better understanding concerning the biomechanics of tendon or ligament insertions as well as the pathogenesis of their failure at a microscopic level.
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