title: Unfocused extracorporeal shock waves induce anabolic effects in osteoporotic rats.
abstract: Unfocused extracorporeal shock waves (UESW) have been shown to have an anabolic effect on bone mass. Therefore we investigated the effects of UESW on bone in osteoporotic rats with and without anti-resorptive treatment. Twenty-week-old rats were ovariectomized (n = 27). One group was treated with saline and another group with Alendronate (ALN) 2.4 µg/kg, 3×/week. UESW were applied 2 weeks after ovariectomy. Thousand UESW were applied to one hind leg, the contra-lateral hind leg was not treated and served as control. With the use of in vivo micro-CT scanning it was shown that in saline treated rats trabecular bone volume fraction (BV/TV) was higher at 2 weeks follow-up in UESW treated legs compared to control legs. However, at 4 and 10 weeks no difference was found. In ALN treated animals UESW led to a pronounced anabolic response resulting in an increase in BV/TV at all time-points. Furthermore, UESW resulted in increased cortical volume (CtV), higher trabecular connectivity and, more plate-like and thicker trabeculae. Biomechanical testing showed that UESW lead to a higher maximum force before failure and higher stiffness in all treatment groups. With histology abundant areas of intramembranous bone formation along the periosteal cortex and within the bone marrow were observed. In conclusion this study shows promising results for the use of UESW in the treatment of osteoporosis, especially when this treatment is combined with an anti-resorptive treatment.
authors.affiliation: Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, PO Box 2040, 3000 CA Rotterdam, The Netherlands. o.vanderjagt@erasmusmc.nl
authors.forename: Olav P
authors.initials: OP
authors.lastname: van der Jagt
authors.forename: Jan H
authors.initials: JH
authors.lastname: Waarsing
authors.forename: Nicole
authors.initials: N
authors.lastname: Kops
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schaden
authors.forename: Holger
authors.initials: H
authors.lastname: Jahr
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
authors.forename: Harrie
authors.initials: H
authors.lastname: Weinans
mesh_terms: D019386:Alendronate / Q000494:pharmacology*; D045930:Anabolic Agents / Q000494:pharmacology; D000818:Animals; D001696:Biomechanical Phenomena / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D010012:Osteogenesis / Q000502:physiology; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D010052:Ovariectomy; D051381:Rats; D017208:Rats, Wistar; D013977:Tibia / Q000000981:diagnostic imaging / Q000502:physiology; D055114:X-Ray Microtomography
chemical_list: D045930:Anabolic Agents; D050071:Bone Density Conservation Agents; D019386:Alendronate