title: Low-Magnitude, High-Frequency Vibration Fails to Accelerate Ligament Healing but Stimulates Collagen Synthesis in the Achilles Tendon.
abstract: BACKGROUND
  Low-magnitude, high-frequency vibration accelerates fracture and wound healing and prevents disuse atrophy in musculoskeletal tissues.
  
  
  OBJECTIVE
  To investigate the role of low-magnitude, high-frequency vibration as a treatment to accelerate healing of an acute ligament injury and to examine gene expression in the intact Achilles tendon of the injured limb after low-magnitude, high-frequency vibration.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Complete surgical transection of the medial collateral ligament (MCL) was performed in 32 Sprague-Dawley rats, divided into control and low-magnitude, high-frequency vibration groups. Low-magnitude, high-frequency vibration started on postoperative day 2, and rats received vibration for 30 minutes a day for 12 days. All rats were sacrificed 2 weeks after the operation, and their intact and injured MCLs were biomechanically tested or used for histological analysis. Intact Achilles tendons from the injured limb were evaluated for differences in gene expression.
  
  
  RESULTS
  Mechanical testing revealed no differences in the ultimate tensile load or the structural stiffness between the control and vibration groups for either the injured or intact MCL. Vibration exposure increased gene expression of collagen 1 alpha (3-fold), interleukin 6 (7-fold), cyclooxygenase 2 (5-fold), and bone morphogenetic protein 12 (4-fold) in the intact Achilles tendon when compared with control tendons (P< .05).
  
  
  CONCLUSIONS
  While no differences were observed in the mechanical or histological properties of the fully transected MCL after low-magnitude, high-frequency vibration treatment, significant enhancements in gene expression were observed in the intact Achilles tendon. These included collagen, several inflammatory cytokines, and growth factors critical for tendons.
  
  
  CONCLUSIONS
  As low-magnitude, high-frequency vibration had no negative effects on ligament healing, vibration therapy may be a useful tool to accelerate healing of other tissues (bone) in multitrauma injuries without inhibiting ligament healing. Additionally, the enhanced gene expression in response to low-magnitude, high-frequency vibration in the intact Achilles tendon suggests the need to further study its potential to accelerate tendon healing in partial injury or repair models.
authors.affiliation: Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Thompson
authors.affiliation: Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Benjamin V
authors.initials: BV
authors.lastname: Keller
authors.affiliation: Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Davis
authors.affiliation: Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Laurence E
authors.initials: LE
authors.lastname: Dahners
authors.affiliation: Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Weinhold
keywords: cyclooxygenase; ligament healing; morphogenetic protein 12; tendon; vibration