RADIAL EXTRACORPOREAL SHOCK WAVE THERAPY (rESWT) INDUCES NEW BONE FORMATION IN VIVO: RESULTS OF AN ANIMAL STUDY IN RABBITS
RADIAL EXTRACORPOREAL SHOCK WAVE THERAPY (rESWT) INDUCES NEW BONE FORMATION IN VIVO: RESULTS OF AN ANIMAL STUDY IN RABBITS
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DOI：
10.1016/j.ultrasmedbio.2012.08.026
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发表时间：
2013-01-01
影响因子：
2.9
通讯作者：
Diehl, Peter
中科院分区：
文献类型：
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作者：
Gollwitzer, Hans;Gloeck, Timo;Diehl, Peter
本研究的目的是研究放射状体外冲击波治疗（rESWT）是否诱导新骨形成，并研究ESWT诱导成骨的时间过程。在13只新西兰白色家兔的一侧后肢上施加4000个脉冲的径向冲击波（0.16 mJ/mm（2）），对侧作为对照。7天后重复治疗。通过皮下注射四环素、钙黄绿素绿色、茜素红和钙黄绿素蓝进行新骨形成的荧光染料序列标记。在第一次rESWT后2周（n = 4）、4周（n = 4）和6周（n = 5）处死动物，并通过荧光显微镜分析骨切片。对荧光染料沉积物进行分类，并采用Fisher精确检验分析显著性。在6周研究期间的所有时间点，rESWT均显著增加了新骨形成。骨化强度在4周后达到峰值，并在研究结束时下降。与背侧皮质相比，位于冲击波装置方向的腹侧皮质的新骨形成显著更高且持续时间更长，强调了ESWT诱导成骨的剂量依赖性过程。通过组织学和放射学评估，未观察到创伤，如出血、骨膜脱离或微骨折。这是第一项研究证明低能量径向冲击波诱导体内新骨形成。根据我们的结果，建议每6周重复ESWT。应用于骨折风险增加的骨区域（例如，例如，在一个实施例中，在骨质疏松症中）是可能的临床适应症。（电子邮件：gollwitzer@bone-and-joint.org）（C）2013年世界医学和生物学超声联合会。
The aim of this study was to investigate if radial extracorporeal shock wave therapy (rESWT) induces new bone formation and to study the time course of ESWT-induced osteogenesis. A total of 4000 impulses of radial shock waves (0.16 mJ/mm(2)) were applied to one hind leg of 13 New Zealand white rabbits with the contralateral side used for control. Treatment was repeated after 7 days. Fluorochrome sequence labeling of new bone formation was performed by subcutaneous injection of tetracycline, calcein green, alizarin red and calcein blue. Animals were sacrificed 2 weeks (n = 4), 4 weeks (n = 4) and 6 weeks (n = 5) after the first rESWT and bone sections were analyzed by fluorescence microscopy. Deposits of fluorochromes were classified and analyzed for significance with the Fisher exact test. rESWT significantly increased new bone formation at all time points over the 6-week study period. Intensity of ossification reached a peak after 4 weeks and declined at the end of the study. New bone formation was significantly higher and persisted longer at the ventral cortex, which was located in the direction to the shock wave device, compared with the dorsal cortex, emphasizing the dose-dependent process of ESWT-induced osteogenesis. No traumata, such as hemorrhage, periosteal detachment or microfractures, were observed by histologic and radiologic assessment. This is the first study demonstrating low-energy radial shock waves to induce new bone formation in vivo. Based on our results, repetition of ESWT in 6-week intervals can be recommended. Application to bone regions at increased fracture risk (e. g., in osteoporosis) are possible clinical indications. (E-mail: gollwitzer@bone-and-joint.org) (C) 2013 World Federation for Ultrasound in Medicine & Biology.