Unfocused extracorporeal shock wave therapy as potential treatment for osteoporosis.
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 = 0.001) and 105% of baseline BV/TV versus 95% at 7 weeks after ESWT (p = 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 = 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.
Department of Orthopaedics, Erasmus Medical Center, Dr. Molenwaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. o.vanderjagt@erasmusmc.nl
Olav P
OP
van der Jagt
Jacqueline C
JC
van der Linden
Wolfgang
W
Schaden
Hans T
HT
van Schie
Tom M
TM
Piscaer
Jan A N
JA
Verhaar
Harrie
H
Weinans
Jan H
JH
Waarsing
D000818:Animals; D015519:Bone Density / Q000528:radiation effects; D005260:Female; D017102:Fracture Healing / Q000528:radiation effects; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D010024:Osteoporosis / Q000532:radiotherapy*; D010052:Ovariectomy; D051381:Rats; D017208:Rats, Wistar; D013977:Tibia / Q000528:radiation effects; D014057:Tomography, X-Ray Computed / Q000379:methods