低强度脉冲超声在肩袖损伤中促进腱骨愈合的研究进展
Research Progress on Low-Intensity Pulsed Ultrasound in Promoting Tendon-to-Bone Healing for Rotator Cuff Injuries
DOI: 10.12677/jcpm.2026.52161, PDF,   
作者: 陈俊宏, 王志强*：西南医科大学附属医院骨与关节外科，四川 泸州；遂宁市中心医院骨科，四川 遂宁
关键词: 低强度脉冲超声；肩袖损伤；腱骨愈合；综述；Low-Intensity Pulsed Ultrasound； Rotator Cuff Injury； Tendon-to-Bone Healing； Review
摘要: 肩袖损伤是临床中最常见的肩关节疾病之一，可引起肩关节持续性疼痛及活动受限，严重影响了患者的生活质量。根据损伤严重程度，治疗方法可分为保守治疗和手术干预。低强度脉冲超声(low-intensity pulsed ultrasound, LIPUS)作为一种非侵入性物理治疗手段，在促进软组织修复方面展现出潜力。本文旨在综述LIPUS在肩袖损伤中促进腱骨愈合治疗的基础研究、临床应用现状及作用机制，以期为临床治疗提供参考。
Abstract: Rotator cuff injury is one of the most common shoulder disorders in clinical practice, often leading to persistent shoulder pain and functional impairment, which significantly affects patients’ quality of life. Treatment options, depending on the severity of the injury, range from conservative management to surgical intervention. Low-intensity pulsed ultrasound (LIPUS), a non-invasive physical therapy modality, has shown promise in promoting soft tissue repair. This article aims to review the fundamental research, current clinical applications, and underlying mechanisms of LIPUS in enhancing tendon-to-bone healing for rotator cuff injuries, with the goal of providing a reference for clinical practice.
文章引用：陈俊宏, 王志强. 低强度脉冲超声在肩袖损伤中促进腱骨愈合的研究进展[J]. 临床个性化医学, 2026, 5(2): 595-601. https://doi.org/10.12677/jcpm.2026.52161

参考文献

[1] Zong, L.Z., Duan, M.M., Yuan, W.W., et al. (2020) Efficacy of Shoulder Arthroscopic Surgery for the Treatment of Rotator Cuff Injury: A Protocol of Systematic Review and Meta-Analysis. Medicine, 99, e20591. [Google Scholar] [CrossRef] [PubMed]
[2] Dang, A. and Davies, M. (2018) Rotator Cuff Disease: Treatment Options and Considerations. Sports Medicine and Arthroscopy Review, 26, 129-133. [Google Scholar] [CrossRef] [PubMed]
[3] Angle, S.R., Sena, K., Sumner, D.R. and Virdi, A.S. (2011) Osteogenic Differentiation of Rat Bone Marrow Stromal Cells by Various Intensities of Low-Intensity Pulsed Ultrasound. Ultrasonics, 51, 281-288. [Google Scholar] [CrossRef] [PubMed]
[4] Qin, L., Lu, H., Fok, P., Cheung, W., Zheng, Y., Lee, K., et al. (2006) Low-Intensity Pulsed Ultrasound Accelerates Osteogenesis at Bone-Tendon Healing Junction. Ultrasound in Medicine & Biology, 32, 1905-1911. [Google Scholar] [CrossRef] [PubMed]
[5] Jiang, X., Savchenko, O., Li, Y., Qi, S., Yang, T., Zhang, W., et al. (2019) A Review of Low-Intensity Pulsed Ultrasound for Therapeutic Applications. IEEE Transactions on Biomedical Engineering, 66, 2704-2718. [Google Scholar] [CrossRef] [PubMed]
[6] Erden, T., Toker, B., Cengiz, O., Ince, B., Asci, S. and Toprak, A. (2020) Outcome of Corticosteroid Injections, Extracorporeal Shock Wave Therapy, and Radiofrequency Thermal Lesioning for Chronic Plantar Fasciitis. Foot & Ankle International, 42, 69-75. [Google Scholar] [CrossRef] [PubMed]
[7] Yang, T., Liang, C., Chen, L., Li, J. and Geng, W. (2020) Low-Intensity Pulsed Ultrasound Alleviates Hypoxia-Induced Chondrocyte Damage in Temporomandibular Disorders by Modulating the Hypoxia-Inducible Factor Pathway. Frontiers in Pharmacology, 11, Article No. 689. [Google Scholar] [CrossRef] [PubMed]
[8] Fu, S.C., Shum, W.T., Hung, L.K., Wong, M.W., Qin, L. and Chan, K. (2008) Low-Intensity Pulsed Ultrasound on Tendon Healing: A Study of the Effect of Treatment Duration and Treatment Initiation. The American Journal of Sports Medicine, 36, 1742-1749. [Google Scholar] [CrossRef] [PubMed]
[9] Doll, J., Moghaddam, A., Daniel, V., Biglari, B., Heller, R., Schmidmaier, G., et al. (2020) LIPUS vs. Reaming in Non-Union Treatment: Cytokine Expression Course as a Tool for Evaluation and Differentiation of Non-Union Therapy. Journal of Orthopaedics, 17, 208-214. [Google Scholar] [CrossRef] [PubMed]
[10] Yao, H., Zhang, L., Yan, S., He, Y., Zhu, H., Li, Y., et al. (2022) Low-Intensity Pulsed Ultrasound/Nanomechanical Force Generators Enhance Osteogenesis of BMSCs through Microfilaments and TRPM7. Journal of Nanobiotechnology, 20, Article No. 378. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, J., Lai, B., Nanayakkara, G., Yang, Q., Sun, Y., Lu, Y., et al. (2019) Experimental Data-Mining Analyses Reveal New Roles of Low-Intensity Ultrasound in Differentiating Cell Death Regulatome in Cancer and Non-Cancer Cells via Potential Modulation of Chromatin Long-Range Interactions. Frontiers in Oncology, 9, Article No. 600. [Google Scholar] [CrossRef] [PubMed]
[12] 富丽萍, 袁立霞, 王杰, 等. 近十年低强度脉冲超声在肌骨疾病治疗中的应用进展[J]. 南方医科大学学报, 2025, 45(3): 661-668.
[13] Wang, Y., Li, J., Qiu, Y., Hu, B., Chen, J., Fu, T., et al. (2018) Low-Intensity Pulsed Ultrasound Promotes Periodontal Ligament Stem Cell Migration through TWIST1-Mediated SDF-1 Expression. International Journal of Molecular Medicine, 42, 322-330. [Google Scholar] [CrossRef] [PubMed]
[14] Egge, N., Arneaud, S.L.B., Fonseca, R.S., Zuurbier, K.R., McClendon, J. and Douglas, P.M. (2021) Trauma-Induced Regulation of VHP-1 Modulates the Cellular Response to Mechanical Stress. Nature Communications, 12, Article No. 1484. [Google Scholar] [CrossRef] [PubMed]
[15] Shi, M.F., Liu, B.Z., Liu, G.H., Wang, P., Yang, M., Li, Y., et al. (2016) Low Intensity-Pulsed Ultrasound Induced Apoptosis of Human Hepatocellular Carcinoma Cells in Vitro. Ultrasonics, 64, 43-53. [Google Scholar] [CrossRef] [PubMed]
[16] Urita, A., Iwasaki, N., Kondo, M., Nishio, Y., Kamishima, T. and Minami, A. (2013) Effect of Low-Intensity Pulsed Ultrasound on Bone Healing at Osteotomy Sites after Forearm Bone Shortening. The Journal of Hand Surgery, 38, 498-503. [Google Scholar] [CrossRef] [PubMed]
[17] Bernal, A., Pérez, L.M., De Lucas, B., Martín, N.S., Kadow-Romacker, A., Plaza, G., et al. (2015) Low-Intensity Pulsed Ultrasound Improves the Functional Properties of Cardiac Mesoangioblasts. Stem Cell Reviews and Reports, 11, 852-865. [Google Scholar] [CrossRef] [PubMed]
[18] Biglari, B., Yildirim, T.M., Swing, T., Bruckner, T., Danner, W. and Moghaddam, A. (2016) Failed Treatment of Long Bone Nonunions with Low Intensity Pulsed Ultrasound. Archives of Orthopaedic and Trauma Surgery, 136, 1121-1134. [Google Scholar] [CrossRef] [PubMed]
[19] 吕晶同, 施又兴, 王云蛟, 等. 腱-骨结合部结构化界面修复的研究进展[J]. 中国修复重建外科杂志, 2019, 33(9): 1064-1070.
[20] Lu, H.H. and Thomopoulos, S. (2013) Functional Attachment of Soft Tissues to Bone: Development, Healing, and Tissue Engineering. Annual Review of Biomedical Engineering, 15, 201-226. [Google Scholar] [CrossRef] [PubMed]
[21] Liu, Y., Thomopoulos, S., Chen, C., Birman, V., Buehler, M.J. and Genin, G.M. (2014) Modelling the Mechanics of Partially Mineralized Collagen Fibrils, Fibres and Tissue. Journal of the Royal Society Interface, 11, Article ID: 20130835. [Google Scholar] [CrossRef] [PubMed]
[22] Rossetti, L., Kuntz, L.A., Kunold, E., Schock, J., Müller, K.W., Grabmayr, H., et al. (2017) The Microstructure and Micromechanics of the Tendon-Bone Insertion. Nature Materials, 16, 664-670. [Google Scholar] [CrossRef] [PubMed]
[23] Lui, P., Zhang, P., Chan, K. and Qin, L. (2010) Biology and Augmentation of Tendon-Bone Insertion Repair. Journal of Orthopaedic Surgery and Research, 5, Article No. 59. [Google Scholar] [CrossRef] [PubMed]
[24] Kovacevic, D., Fox, A.J., Bedi, A., Ying, L., Deng, X., Warren, R.F., et al. (2011) Calcium-Phosphate Matrix with or without TGF-β3 Improves Tendon-Bone Healing after Rotator Cuff Repair. The American Journal of Sports Medicine, 39, 811-819. [Google Scholar] [CrossRef] [PubMed]
[25] Berber, R., Aziz, S., Simkins, J., Lin, S.S. and Mangwani, J. (2020) Low Intensity Pulsed Ultrasound Therapy (LIPUS): A Review of Evidence and Potential Applications in Diabetics. Journal of Clinical Orthopaedics and Trauma, 11, S500-S505. [Google Scholar] [CrossRef] [PubMed]
[26] Lee, H.J., Choi, B.H., Min, B., Son, Y.S. and Park, S.R. (2006) Low‐Intensity Ultrasound Stimulation Enhances Chondrogenic Differentiation in Alginate Culture of Mesenchymal Stem Cells. Artificial Organs, 30, 707-715. [Google Scholar] [CrossRef] [PubMed]
[27] Korstjens, C.M., Nolte, P.A., Burger, E.H., et al. (2004) Stimulation of Bone Cell Differentiation by Low-Intensity Ultrasound? A Histomorphometric in Vitro Study. Journal of Orthopaedic Research, 22, 495-500. [Google Scholar] [CrossRef] 
[28] Hu, J., Qu, J., Xu, D., Zhang, T., Qin, L. and Lu, H. (2014) Combined Application of Low‐Intensity Pulsed Ultrasound and Functional Electrical Stimulation Accelerates Bone-Tendon Junction Healing in a Rabbit Model. Journal of Orthopaedic Research, 32, 204-209. [Google Scholar] [CrossRef] [PubMed]
[29] Lovric, V., Ledger, M., Goldberg, J., Harper, W., Bertollo, N., Pelletier, M.H., et al. (2012) The Effects of Low‐Intensity Pulsed Ultrasound on Tendon‐Bone Healing in a Transosseous‐Equivalent Sheep Rotator Cuff Model. Knee Surgery, Sports Traumatology, Arthroscopy, 21, 466-475. [Google Scholar] [CrossRef] [PubMed]
[30] Lai, W.C., Iglesias, B.C., Mark, B.J. and Wang, D. (2021) Low‐Intensity Pulsed Ultrasound Augments Tendon, Ligament, and Bone-Soft Tissue Healing in Preclinical Animal Models: A Systematic Review. Arthroscopy, 37, Article No. 2318. [Google Scholar] [CrossRef] [PubMed]
[31] Khanna, A., Nelmes, R.T.C., Gougoulias, N., Maffulli, N. and Gray, J. (2008) The Effects of LIPUS on Soft-Tissue Healing: A Review of Literature. British Medical Bulletin, 89, 169-182. [Google Scholar] [CrossRef] [PubMed]
[32] Chazaud, B. (2014) Macrophages: Supportive Cells for Tissue Repair and Regeneration. Immunobiology, 219, 172-178. [Google Scholar] [CrossRef] [PubMed]
[33] Gordon, S. and Martinez, F.O. (2010) Alternative Activation of Macrophages: Mechanism and Functions. Immunity, 32, 593-604. [Google Scholar] [CrossRef] [PubMed]
[34] Xu, Z.H., Li, S.C., Wan, L.Y., Hu, J., Lu, H. and Zhang, T. (2023) Role of Low‐Intensity Pulsed Ultrasound in Regulating Macrophage Polarization to Accelerate Tendon-Bone Interface Repair. Journal of Orthopaedic Research, 41, 919-929. [Google Scholar] [CrossRef] [PubMed]
[35] Lu, H., Qin, L., Cheung, W., Lee, K., Wong, W. and Leung, K. (2008) Low-Intensity Pulsed Ultrasound Accelerated Bone-Tendon Junction Healing through Regulation of Vascular Endothelial Growth Factor Expression and Cartilage Formation. Ultrasound in Medicine & Biology, 34, 1248-1260. [Google Scholar] [CrossRef] [PubMed]
[36] Wang, C.J., Ko, J.Y., Chou, W.Y., Hsu, S., Ko, S., Huang, C., et al. (2014) Shockwave Therapy Improves Anterior Cruciate Ligament Reconstruction. Journal of Surgical Research, 188, 110-118. [Google Scholar] [CrossRef] [PubMed]
[37] Fu, L.P., et al. (2025) Advances of Low-Intensity Pulsed Ultrasound for Treatment of Musculoskeletal Disorders in the Past Decade. Journal of Southern Medical University, 45, 661-668.
[38] 侯太甫, 殷恒斌, 许梦雅, 等. 筋膜手法联合低强度脉冲聚焦超声治疗肩袖损伤的疗效观察[J]. 中华物理医学与康复杂志, 2025, 47(7): 638-641.
[39] Xue, X., Kuati, A., Fu, H., Song, Q., Liu, Q. and Cui, G. (2024) Effect of Low-Intensity Pulsed Ultrasound on Postoperative Rehabilitation of Rotator Cuff Tears: Protocol for a Systematic Review and Meta-Analysis. PLOS ONE, 19, e0308354. [Google Scholar] [CrossRef] [PubMed]
[40] Wu, B., Zhang, T., Chen, H., Shi, X., Guan, C., Hu, J., et al. (2024) Exosomes Derived from Bone Marrow Mesenchymal Stem Cell Preconditioned by Low-Intensity Pulsed Ultrasound Stimulation Promote Bone-Tendon Interface Fibrocartilage Regeneration and Ameliorate Rotator Cuff Fatty Infiltration. Journal of Orthopaedic Translation, 48, 89-106. [Google Scholar] [CrossRef] [PubMed]