[Effects of extracorporeal shock waves (ESW) on human bone marrow cell cultures].
BACKGROUND
Extracorporeal shockwave therapy (ESWT) is a new method of treating insertion tendopathy and pseudo-arthrosis, the clinical importance of which cannot yet be definitively assessed, and the underlying mechanisms of which are still unclear.


OBJECTIVE
To develop an experimental set-up enabling the standardised application of ESWT to human bone marrow cell culture and the determination of the effect of ESWT.


METHODS
After 14 days incubation, human bone marrow cell cultures were subjected to ESWT using 200/500 pulses at an energy flux densities ED + of 0.03, 0.04, 0.07, 0.11 and 0.25 millijoule/mm2. Samples were obtained for LDH measurement 15 minutes, 4 h and 18 h after ESWT. Transmission light microscopy was carried out before and after ESWT to determine cell numbers and for morphological analysis.


RESULTS
Gaps in the cellular tissue first appear at an energy of 0.01 millijoule/mm2. At energies of 0.25 millijoule/mm2, morphologically altered cells, thinned out cellular tissue with a cell-free focal zone are found. At low energy levels, defects have been repaired ca. 1 week after ESWT. No significant increase in LDH was detected at any of the energy levels applied.


CONCLUSIONS
Increasing energy and higher pulse frequency is associated with an increase in the size and number of holes in cellular tissue and in cell separation. Regeneration capability (regrowth, sprouting, normal cell form) decreases as the energy level increases. Changes can be detected even at the lowest energy flux densities, which up until now had been assumed to have no effect on cell morphology or number. The standardised application of ESWT to human bone marrow cell cultures provides reproducible results that can be controlled by a placebo ESWT application.
Haake
M
M
Orthopädische Klinik, Philipps-Universität Marburg. haake2@mailer.uni-marburg.de
Wessel
C
C
Wilke
A
A
D001854:Bone Marrow Cells / Q000166:cytology* / Q000201:enzymology; D002478:Cells, Cultured; D019220:High-Energy Shock Waves; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008853:Microscopy
D007770:L-Lactate Dehydrogenase
Einwirkung extrakorporaler Stosswellen (ESW) auf humane Knochenmarkszellkulturen.