High-Energy Shock Waves for the Treatment of Nonunions: An Experiment on Dogs

Johannes, E.J.; Kaulesar, Dinesh M.K.S.; Matura, Eike

doi:10.1006/jsre.1994.1139

Cited by 113 publications

(78 citation statements)

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“…Minor bleeding and a transient disuse of the treated leg were seen directly after ESWT therapy, as described in other studies. 9,23 Disruption of trabeculae or fracture of the cortex were described when focused shock wave therapy with high energy levels (0.54-0.9 mJ/mm 2 ) or when a high number of pulses (!1,500) were applied. 9,10,24 However, these side effects occur in a dose-related manner, and since we used unfocused shock waves with an energy flux density of 0.16 mJ/mm 2 , it is not surprising that we did not find these side effects.…”

Section: Discussionmentioning

confidence: 99%

Unfocused extracorporeal shock wave therapy as potential treatment for osteoporosis

Jagt¹,

Linden²,

Schaden

et al. 2009

Journal Orthopaedic Research

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Extracorporeal shock wave therapy (ESWT) influences the differentiation of bone marrow stroma cells towards osteoprogenitors and increases the expression of several growth factors. To assess whether unfocused ESWT might serve as a treatment for osteoporosis, we examined the bone architecture dynamics of ESWT-treated and untreated rat tibiae using in vivo micro-computed tomography (CT) scanning. In addition, the effects of ESWT on fracture healing, using a bilateral fibula osteotomy, were examined. Unilateral unfocused ESWT with 2,000 pulses and an energy flux density of 0.16 mJ/mm 2 was applied to the hind leg of ovariectomized and sham-ovariectomized rats. A single treatment with unfocused ESWT resulted in a higher trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-ovariectomized animals. Three weeks after ESWT, BV/TV was 110% of baseline BV/TV in treated legs versus 101% in untreated contralateral control legs (p ¼ 0.001) and 105% of baseline BV/TV versus 95% at 7 weeks after ESWT (p ¼ 0.0004). In ovariectomized rats, shock wave treatment resulted in a diminished bone loss. At 7 weeks, the BV/TV of the treated legs was 50% of baseline BV/TV, whereas in untreated control legs this was 35% (p ¼ 0.0004). ESWT did not influence acute fracture healing. This study shows that bone microarchitecture can be affected by unfocused shock waves, and indicates that unfocused ESWT might be useful for the treatment of osteopenia and osteoporosis. ß

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Section: Discussionmentioning

confidence: 99%

Unfocused extracorporeal shock wave therapy as potential treatment for osteoporosis

Jagt¹,

Linden²,

Schaden

et al. 2009

Journal Orthopaedic Research

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“…In another experiment of this kind Johannes et al (1994) used dogs to establish a model of delayed fracture healing that was considered especially suited to investigating the treatment of pseudarthrosis by shock waves. The fracture gap remains wide after osteotomy of the distal radius, and callus formation does not take place over the following 12 weeks.…”

Section: Dog Radius Osteotomymentioning

confidence: 99%

Effect of Extracorporeal Shock Waves on Bone: A Review of Shock Wave Experiments and the Mechanism of Shock Wave Action

Delius¹,

Draenert²,

Draenert³

et al. 1998

Extracorporeal Shock Waves in Orthopaedics

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“…ESWT may produce microfractures of bone [5,7], which, in turn, can stimulate neovascularisation, osteoblast formation, and bone healing. Scheberger and Senge thought ESW had a biological effect on bone derivation, which led to the bone creeping substitution of the scar between bone fracture terminals and finally led to bony healing [14].…”

Section: Discussionmentioning

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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High-Energy Shock Waves for the Treatment of Nonunions: An Experiment on Dogs

Cited by 113 publications

References 0 publications

Unfocused extracorporeal shock wave therapy as potential treatment for osteoporosis

Unfocused extracorporeal shock wave therapy as potential treatment for osteoporosis

Effect of Extracorporeal Shock Waves on Bone: A Review of Shock Wave Experiments and the Mechanism of Shock Wave Action

Extracorporeal shock wave treatment in nonunions of long bone fractures

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