Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head

Wen, Yue; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao

doi:10.1097/phm.0000000000000484

Cited by 12 publications

(17 citation statements)

References 28 publications

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“…In recent years, an increasing number of patients are being diagnosed with osteoarthritis, which has a notable impact on human health and quality of life (2,3). The causes of osteoarthritis are complex, and the pathogenesis related to this disease is not well understood (4).…”

Section: Introductionmentioning

confidence: 99%

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Huang

Sha²,

Yang

et al. 2018

Exp Ther Med

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Abstract. Knee osteoarthritis is a degenerative disease that may develop due ageing, obesity, strain, congenital abnormal joints, joint deformity or trauma. It is caused by many factors, such as degradation of articular cartilage injury, joint edge and subchondral bone hyperplasia of reactivity. Platelet-rich plasma (PRP) is an autologous blood sample that contains highly concentrated platelets and multiple cell growth factors. PRP promotes synovial cell proliferation and differentiation and may recover cartilage morphology. In the present study, the clinical efficacy of PRP was investigated in patients with knee osteoarthritis aged between 18 and 30 years in a phase-III clinical study. Following an 8-week baseline, patients with knee osteoarthritis were randomized into once-weekly, double-blind treatment with PRP (2-14 ml) or placebo groups. The results indicated that patients with osteoarthritis treated with PRP had modulated plasma concentrations of inflammatory factors and pro-angiogenic factors compared with the placebo group. Treatment responses were assessed by median percent reduction in inflammatory and pro-angiogenic factors and these improved with PRP treatment compared with the placebo. Clinical data indicated that PRP alleviated knee osteoarthritis and reduced humoral and cellular immune responses that led to beneficial effects on histological parameters. Inflammation was significantly alleviated in patients receiving PRP compared with the placebo group. The most common treatment-emergent adverse events in the presence of PRP were hypertension and proteinuria. In conclusion, treatment with PRP for patients with knee osteoarthritis presented beneficial effects in alleviating joint inflammation, cartilage destruction and bone damage, and repairing joint tissue. These results suggested that PRP may be a potential therapeutic agent for knee osteoarthritis.

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Section: Introductionmentioning

confidence: 99%

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Huang

Sha²,

Yang

et al. 2018

Exp Ther Med

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“…Eventually, 17 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] studies were considered to be eligible for this systematic review, 16 [13][14][15][16][17][18][19][20][21][23][24][25][26][27][28][29] of which were published in English and only 1 [22] was published in Chinese. Next, we extracted 3 types of useful data from included studies and imported them into different tables: basic information of included publications ( Table 1); technological details of extracorporeal shockwave therapy ( Table 2) and therapeutic effect assessment indexes of included studies ( Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…As for the study design, 2 [15,28] were case reports, 9 [13,14,16,[22][23][24][25]27,29] were open label trials, 2 [20,26] were cohorts, and 4 [17][18][19]24] were randomized controlled trials (RCTs). Twelve [13,14,[16][17][18][19][20][21][23][24][25]27] studies were prospective ones and 5 [15,22,26,28,29] were retrospective ones. All patients were diagnosed with ONFH.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven [13,15,16,20,[22][23][24][26][27][28][29] studies only investigated the effect of extracorporeal shockwave, 4 [14,17,19,25] compared the performance of ESWT with operations (jointpreserving surgeries or endoprosthetic replacement of joint) and 2 [18,21] compared the effect of ESWT with cocktail therapy (ESWT combined with other noninvasive modalities). Sixteen [13][14][15][16][18][19][20][21][22][23][24][25][26][27][28][29] studies presented the visual analog scale (VAS) and/or Harris hip score before and after the treatment as evaluation indicators. Other outcome assessment indexes provided by these literatures included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the 12item Short Form (SF-12) Survey, magnetic resonance imaging manifestation, the need for surgical intervention as well as numbers of patients with improved, stable and deteriorating conditions.…”

Section: Resultsmentioning

confidence: 99%

“…They pointed out that the improvement of Harris hip scores was mainly due to the reduction of pains and the lesion decrease on MRI after ESWT was not statistically significant (at the same time, a significant reduction of bone marrow edema was indeed observed). Above-mentioned studies used focused shockwave while in 2016, Ma et al [28] described a case of advanced ONFH opt not to THA and treated with radial ESWT, in which a satisfactory result was obtained. Larger-scale clinical trials are needed to confirm this conclusion.…”

Section: Therapeutic Effect Of Eswt For Onfhmentioning

confidence: 99%

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Extracorporeal shockwave therapy in osteonecrosis of femoral head

et al. 2017

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Background:Osteonecrosis is an incapacitating disorder with high morbidity. Though extracorporeal shockwave therapy (ESWT) provides a noninvasive treatment option, controversial subjects still exist about its effectiveness, indications, and mechanism of action.Methods:An electronic databases search was performed using PubMed, Embase, and the Cochrane library to collect clinical trials, case reports, and cases series on this topic and then useful data were extracted and appraised by experienced clinicians. We evaluated the quality of included evidences by using the Oxford Centre for evidence-based medicine (EBM) Levels of Evidence.Results:A total of 17 articles including 2 case reports, 9 open label trials, 2 cohorts, and 6 randomized controlled trials were considered to be eligible for this systematic review. Visual analog scale (VAS), Harris hip scores, and the imaging results were the frequently-used outcome estimates of included studies.Conclusion:By systematically analyzing these evidences, we could conclude that ESWT could act as a safe and effective method to improve the motor function and relieve the pain of patients with osteonecrosis of femoral hip, especially those at early stage. Imaging revealed that bone marrow edema was significantly relieved, but the necrotic bone could not be reversed after ESWT. This technique could slow or even block the progression of ONFH and therefore reduce the demand for surgery. Collaboration with other conservative modalities would not improve the curative benefits of ESWT. Meanwhile, ONFH with various risk factors showed similar reaction to this noninvasive treatment method. However, these conclusions should be interpreted carefully for the low-quality of included publications and further studies are requisite to validate the effect of ESWT in ONFH.

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rESWT promoted angiogenesis via Bach1/Wnt/β-catenin signaling pathway

Yang,

Guo,

Kang

et al. 2024

Sci Rep

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Previous reports have established that rESWT fosters angiogenesis, yet the mechanism by which rESWT promotes cerebral angiogenesis remains elusive. rESWT stimulated HUVECs proliferation as evidenced by the CCK-8 test, with an optimal dosage of 2.0 Bar, 200 impulses, and 2 Hz. The tube formation assay of HUVECs revealed that tube formation peaked at 36 h post-rESWT treatment, concurrent with the lowest expression level of Bach1, as detected by both Western blot and immunofluorescence. The expression level of Wnt3a, β-catenin, and VEGF also peaked at 36 h. A Bach1 overexpression plasmid was transfected into HUVECs, resulting in a decreased expression level of Wnt3a, β-catenin, and VEGF. Upon treatment with rESWT, the down-regulation of Wnt3a, β-catenin, and VEGF expression in the transfected cells was reversed. The Wnt/β-catenin inhibitor DKK-1 was utilized to suppress Wnt3a and β-catenin expression, which led to a concurrent decrease in VEGF expression. However, rESWT treatment could restore the expression of these three proteins, even in the presence of DKK-1. Moreover, in the established OGD model, it was observed that rESWT could inhibit the overexpression of Bach1 and enhance VEGF and VEGFR-2 expression under the OGD environment.

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Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head

Abstract: Supplemental digital content is available in the text.

Cited by 12 publications

References 28 publications

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

Extracorporeal shockwave therapy in osteonecrosis of femoral head

rESWT promoted angiogenesis via Bach1/Wnt/β-catenin signaling pathway

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