High-Energy Extracorporeal Shock Wave Treatment of Nonunions

Rompe, Jan D.; Rosendahl, Thomas; Schöllner, C.; Theis, C.

doi:10.1097/00003086-200106000-00014

Cited by 129 publications

(103 citation statements)

References 30 publications

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“…For bone formation to occur, osteoblast precursor cells must migrate from the bone marrow compartment to bone surfaces, where they adhere, differentiate, and deposit the bone matrix. After transient or long term treatment of ESW, a positive effect on osteogenic activation has been shown according to data from studies on osteoblast proliferation and differentiation either in vitro or in vivo (9,10). The promotion of osteoblast proliferation and differentiation is well documented to be through significant inductions of numerous cellular factors, such as bone morphogenetic proteins (11), transforming growth factor (TGF-␤1) (12), and vascular endothelial growth factor (VEGF) (12,13), as well as osteocalcin (14).…”

Section: Extracorporeal Shock Wave (Esw)mentioning

confidence: 99%

Optimal Intensity Shock Wave Promotes the Adhesion and Migration of Rat Osteoblasts via Integrin β1-mediated Expression of Phosphorylated Focal Adhesion Kinase

Chen

et al. 2012

Journal of Biological Chemistry

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Background:The effects of extracorporeal shock wave (ESW) on adhesion and migration of osteoblasts have not been reported until now. Results: Optimal intensity shock wave promotes osteoblast adhesion and migration. Conclusion: ESW promotes the adhesion and migration of osteoblasts via integrin ␤1-mediated expression of phosphorylated FAK.Significance: This provides a mechanistic basis for improving the effectiveness of ESW treatment in fracture healing and tissue engineering.

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Section: Extracorporeal Shock Wave (Esw)mentioning

confidence: 99%

Optimal Intensity Shock Wave Promotes the Adhesion and Migration of Rat Osteoblasts via Integrin β1-mediated Expression of Phosphorylated Focal Adhesion Kinase

Chen

et al. 2012

Journal of Biological Chemistry

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“…By focusing the acoustic waves with a semi-ellipsoid reflector, the waves can be transmitted to a specific tissue site [29]. ESW have been found beneficial for the healing process of nonunion, acute fracture and calcified tendinitis [25,32,39,40]. It has been scintographically and sonographically implicated that local blood flow and metabolism of bone and Achilles tendon in rabbits were affected by ESW treatment [26,3 I].…”

Section: Introductionmentioning

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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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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“…There are multiple studies supporting its use in the treatment of fracture nonunions, but little literature supporting use in stress fractures [36][37][38][39][40][41][42][43]. The procedure is safe and fast and is a useful adjunct when treating navicular stress fractures operatively and non-operatively.…”

Section: Shock Wave Therapymentioning

confidence: 99%

Tarsal navicular stress fractures

Shakked

Walters

O’Malley

2017

Curr Rev Musculoskelet Med

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Purpose of review Navicular stress fractures are common in athletes and management is debated. This article will review the evaluation and management of navicular stress fractures. Recent findings Various operative and non-operative adjunctive treatment modalities are reviewed including the relevance of vitamin D levels, use of shock wave therapy and bone marrow aspirate concentrate (BMAC), and administration of teriparatide. Surgical treatment may be associated with earlier return to sports. Summary The author's preferred treatment algorithm with corresponding images is presented which allows for safe and rapid return to activities in the athletic patient. Future research is needed in evaluating the preventative effects of vitamin D and use of other adjunctive treatments to increase the healing rates of this fracture.

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High-Energy Extracorporeal Shock Wave Treatment of Nonunions

Cited by 129 publications

References 30 publications

Optimal Intensity Shock Wave Promotes the Adhesion and Migration of Rat Osteoblasts via Integrin β1-mediated Expression of Phosphorylated Focal Adhesion Kinase

Optimal Intensity Shock Wave Promotes the Adhesion and Migration of Rat Osteoblasts via Integrin β1-mediated Expression of Phosphorylated Focal Adhesion Kinase

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

Tarsal navicular stress fractures

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