Biological effects of shock waves: In vivo effect of high energy pulses on rabbit bone

Delius, Michael; Draenert, K.; Diek, Y. Al; Draenert, Y.

doi:10.1016/0301-5629(95)00030-5

Cited by 160 publications

(102 citation statements)

References 12 publications

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“…In contrast to previous studies demonstrating highenergy ESW (0.5 and 0.9 mJ/mm2 EFD) damaged bone tissue in rabbits [8,26], we showed that ESW treatment (0.16 mJ/mm2 EFD) did not induce side effects in rats. We speculate the discrepancy that influence of ESW on bone tissue depends on EFD and experimental animals.…”

Section: Discussioncontrasting

confidence: 99%

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Recruitment of mesenchymal stem cells and expression of TGF-$beta;1 and VEGF in the early stage of shock wave-promoted bone regeneration of segmental defect in rats

CHEN¹

2004

Journal of Orthopaedic Research

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Extracorporeal shock wave (ESW) treatment has recently been established as a method to enhance bone repair. Here, we reported that ESW-promoted healing of segmental defect via stimulation of mesenchymal stem cell recruitment and differentiation into bone forming cells. Rats with a segmental femoral defect were exposed to a single ESW treatment (0.16 mJ/mm?, 1 Hz, 500 impulses). Cell morphology and histological changes in the defect region were assessed 3, 7, 14, and 28 days post-treatment. Presence of mesenchymal stem cell was assayed by immuno-staing for RPS9, a recently discovered marker, and also production of TGF-PI and VEGF was monitored. ESW treatment increased total cell density and the proportion of RP59 positive cells in the defect region. High numbers of round-and cuboidal-shaped cells strongly expressing RPS9 were initially found. Later, the predominant cell type was spindle-shaped fibroblastic cells, subsequently, aggregates of osteogenic and chondrogenic cells were observed. Histological observation suggested that bone marrow stem cells were progressively differentiated into osteoblasts and chondrocytes. RP59 staining was initially intense and decreased with the appearance of expression depended on the differentiation states of osteogenic and chondrogenic cells during the regeneration phase. Mature chondrocytes and osteoblasts exhibited only slight RP59 immunoreactivity. Expression of TGF-PI and VEGF-A mRNA in the defect tissues was also significantly increased ( P < 0.05) after ESW treatment as determined by RT-PCR. Intensive TGF-PI immuno-reactivity was induced immediately, whereas a lag period was observed for VEGF-A. Chondrocytes and osteoblasts at the junction of ossified cartilage clearly exhibited VEGF-A expression. Our findings suggest that recruitment of meseoblasts at the junction of ossified cartilage clearly exhibited mesenchymal stem cells is a critical step in bone reparation that is enhanced by ESW treatment. TGF-P1 and VEGF-A are proposed to play a chemotactic and mitogenic role in recruitment and differentiation of mesenchymal stem cells.

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Section: Discussioncontrasting

confidence: 99%

“…In normal bone model, ESW potentially causes detachment of periosteum from bone and hematoma, as well as altered blood flow and bone metabolism in rabbits [8,26]. These effects may enhance recruitment and proliferation of marrow-, muscle-and periosteumderived osteogenic progenitor cells to the segmental defect.…”

Section: Discussionmentioning

confidence: 99%

Recruitment of mesenchymal stem cells and expression of TGF-$beta;1 and VEGF in the early stage of shock wave-promoted bone regeneration of segmental defect in rats

CHEN¹

2004

Journal of Orthopaedic Research

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“…Since the 1990s ESWT has been successfully used in bone nonunion, although the mechanism is still not very clear. The benefit of shock wave therapy for nonunions has already been reported in various experimental [2][3][4]10] and clinical studies [1,12,13,17]. More recently, shock wave has been introduced as therapy for other orthopaedic pathologies such as tendinopathies and bone necrosis [8,9,16,18].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal shock wave treatment in nonunions of long bone fractures

Zhang

Jiang

Chen

et al. 2008

International Orthopaedics (SICOT)

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We reviewed the clinical results of the past 7 years in order to investigate the effect of extracorporeal shock wave therapy (ESWT) in nonunions of long bone fracture. Sixty-nine patients with 69 nonunions (22 femora, 28 tibiae, 13 humeri, 5 radii, and 1 ulna) were treated with extracorporeal shock waves. The technical parameters were 6,000 to 10,000 impulses at 28 kV (0.62 mJ/mm 2 energy flux density) for the femur and tibia, 4,000 impulses at 24 kV for the humerus (0.56 mJ/mm 2 energy flux density), and 3,000 impulses at 24 kV (0.56 mJ/mm 2 energy flux density) for the radius and ulna. Sixty-six patients were followed up. The total successful rate of bony union was 75.4%. ESWT was successful in hypertrophic nonunions and seemed to have no evident effect in atrophic nonunions. We believe that extracorporeal shock wave therapy may be a good choice for nonunions of long bone fracture especially in hypertrophic nonunions.Résumé L'objectif de cette étude a été d'évaluer cliniquement les résultats observés sur les 7 dernières années lde a technique extracorporelle "schock wave" (ESWT) sur le traitement des pseudarthroses des os longs. Matériel et méthode : 69 patients présentant 69 pseudarthroses (22 fémurs, 28 tibias, 13 humérus, 5 radius et 1 cubitus) ont été traités selon cette méthode. Les paramètres techniques étaient de 6000 et de 10000 impulsions à 28 kV (062 mJ/mm2) pour le fémur et le tibia, 4000 impulsions à 24 kV pour l'humérus (0.56 mJ/mm2), 3000 impulsions à 24 kV (0.56 mJ/mm2) pour le radius et le cubitus. Résultats : 66 patients ont été suivis pendant au moins 12 mois. Le taux de consolidation a été de 75,4%. La ESWT est une technique qui permet de traiter une pseudarthrose hypertrophique alors qu'elle a peu d'effet sur les pseudarthroses atrophique. Conclusion : nous pensons que cette technique est une technique de choix pour les pseudarthroses des os longs spécialement lorsque ces pseudarthroses sont hypertrophiques.

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“…5 Experimental studies suggested that ESWT stimulates osteoblastic activity by causing microtrauma or microfractures, thereby enhancing fracture healing. [6][7][8] It is assumed that The Effectiveness of Extracorporeal Shock Wave Therapy in Myofascial Pain Syndrome…”

mentioning

confidence: 99%

Comparison of the Effectiveness of Two Different Extracorporeal Shock Wave Therapy Regimens in the Treatment of Patients With Myofascial Pain Syndrome

et al. 2014

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Objectives: This study aims to compare the effectiveness of two different regimens of extracorporeal shock wave therapy (ESWT) in the treatment of myofascial pain syndrome. Patients and methods: Sixty four patients with active myofascial trigger points in the trapezius muscle were included in this study. Patients were randomized into two groups as patients undergoing a single session of low-energy [energy flux density (ED=0.25 mJ/mm 2 )] ESWT (group 1) and patients undergoing three sessions of ESWT with the same energy density, with one-week intervals (group 2). The effectiveness of therapy was evaluated using the number of trigger points, the Patient Global Assessment and Physician Global Assessment scales, the Neck Pain and Disability Scale, the Nottingham Health Profile and the Hamilton Anxiety Rating Scale prior to therapy and at the end of three and 12 weeks. Results: No serious complication associated with ESWT application was observed. At the end of the treatment, statistically significant improvements were achieved in the number of trigger points, pain, quality of life, and anxiety scores of patients in both groups (p<0.01). When the groups were compared regarding the effectiveness of the treatment, the improvements in the group receiving three sessions of ESWT were higher except for the anxiety scores (p<0.05). Conclusion: Low-energy ESWT is a safe and well-tolerated therapy for patients with myofascial pain syndrome and can be more efficient when administered as a three-session treatment regimen.

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Biological effects of shock waves: In vivo effect of high energy pulses on rabbit bone

Cited by 160 publications

References 12 publications

Recruitment of mesenchymal stem cells and expression of TGF-$beta;1 and VEGF in the early stage of shock wave-promoted bone regeneration of segmental defect in rats

Recruitment of mesenchymal stem cells and expression of TGF-$beta;1 and VEGF in the early stage of shock wave-promoted bone regeneration of segmental defect in rats

Extracorporeal shock wave treatment in nonunions of long bone fractures

Comparison of the Effectiveness of Two Different Extracorporeal Shock Wave Therapy Regimens in the Treatment of Patients With Myofascial Pain Syndrome

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