title: Early effects of extracorporeal shock wave treatment on osteoblast-like cells: a comparative study between electromagnetic and electrohydraulic devices.
abstract: BACKGROUND
  Extracorporeal shockwave therapy (ESWT) has been increasingly applied to treat orthopedic and musculoskeletal pathologies. ESWT involves mechanical perturbations that, as with other physical therapies, can result in mechanical stimuli to a large number of cells, including bone cells. The aim of this study was to evaluate the effects of shock waves on osteoblast-like cells (MG63) when using two different generators of shock waves (electrohydraulic and electromagnetic devices), in terms of cell damage, cell viability, osteogenic phenotype expression, and cytokine production.
  
  
  METHODS
  MG63 cells were suspended in 1.5 mL screw-cap cryotubes (1 x 10 cells/mL), containing phosphate buffer solution (PBS), which were maintained at 37 degrees C during all the experimental times. Two levels of energy flux density (EFD) were evaluated for each device: 0.15 to 0.18 mJ/mm2 and 0.40 mJ/mm2. Cells were then cultivated for 72 hours starting from a concentration of 1 x 10 cells/mL, and biological activity and viability were evaluated 24 and 72 hours after treatment.
  
  
  RESULTS
  The results obtained demonstrate that the factors most affecting osteoblast activity involve both the device and the level of EFD selected, and they must be considered all together.
  
  
  CONCLUSIONS
  The use of the electromagnetic device and a level of EFD lower than 0.40 mJ/mm2 would appear to induce fewer immediate cytodestructive effects and better stimulate subsequent proliferation and the synthetic activity of MG63.
authors.affiliation: Experimental Surgery Department, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Martini
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giavaresi
authors.forename: Milena
authors.initials: M
authors.lastname: Fini
authors.forename: Veronica
authors.initials: V
authors.lastname: Borsari
authors.forename: Paola
authors.initials: P
authors.lastname: Torricelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Giardino
mesh_terms: D002470:Cell Survival / Q000502:physiology; D002478:Cells, Cultured; D004307:Dose-Response Relationship, Radiation; D055590:Electromagnetic Phenomena; D019220:High-Energy Shock Waves; D006801:Humans; D010006:Osteoblasts / Q000528:radiation effects*; D013997:Time Factors