title: Lithotripsy stimulates new bone formation and mitigates loss of bone due to disuse in aged rats.
abstract: BACKGROUND
  Normal "wear and tear" of bones during weight bearing activity creates microdamage that triggers bone to heal itself.
  
  
  OBJECTIVE
  A controlled laboratory study was carried out to determine the effect of lithotripsy on bone apposition and resorption in osteopenic, hind-limb suspended, aged rats compared to age-matched controls allowed normal weight bearing (cage) activity.
  
  
  METHODS
  First, we tested the feasibility of using a clinical lithotripsy device, designed for treatment of kidney stones, to create microdamage in bone. In a second step, we tested the hypothesis that microdamage induced through lithotripsy treatment increases bone apposition in aged rats. In a third step, we exposed osteopenic, aged rats to lithotripsy to evaluate the effectiveness of lithotripsy in counteracting bone loss due to simulated disuse.
  
  
  RESULTS
  Both in aged, weight bearing as well as aged, osteopenic rats, we showed that lithotripsy effectively increases the area of bone apposition along the periosteal and endosteal surfaces. While new bone apposition concentrates in areas of lithotripsy treatment in aged bone of weight bearing rats, new bone apposition extends beyond the immediate treatment site (to the contralateral limb) of osteopenic animals. Furthermore, bone resorption decreases in osteopenic (hindlimb suspended) and aged rat femora treated with lithotripsy, compared to baseline and hindlimb suspended controls. This decrease in resorption is not observed in the contralateral limb of osteopenic animals.
  
  
  CONCLUSIONS
  Taken as a whole, lithotripsy may offer a viable treatment method for disuse osteopenia or osteoporosis, particularly for aging individuals or for those who are limited in their weight bearing activities.
authors.affiliation: Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA Department of Mechanical & Aerospace Engineering, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Knothe Tate
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Jared
authors.initials: J
authors.lastname: O'Leary
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: McNamara
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Lan
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ulf R
authors.initials: UR
authors.lastname: Knothe
mesh_terms: D000375:Aging / Q000502:physiology; D000818:Animals; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000628:therapy*; D001862:Bone Resorption / Q000209:etiology / Q000628:therapy*; D004195:Disease Models, Animal; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D010012:Osteogenesis / Q000502:physiology*; D051381:Rats; D057170:Translational Research, Biomedical; D016474:Weight-Bearing / Q000502:physiology
keywords: Aging; bone; lithotripsy; osteopenia; translational research