title: Effects of shock wave therapy on glycosaminoglycan expression during bone healing.
abstract: BACKGROUND
  Several cases of delayed bone consolidation have been treated with extracorporeal shock wave therapy (ESWT) to improve bone healing and a key role of the extracellular matrix glycosaminoglycans in osteogenesis has been suggested.
  
  
  OBJECTIVE
  In this study, we aimed to identify and quantify the amount of sulfated glycosaminoglycans (GAG) and hyaluronic acid (HA) within rat femurs following bone drilling and treatment with shock waves.
  
  
  METHODS
  To identify and quantify the sulfated glycosaminoglycans (GAG) and hyaluronic acid (HA) within rat femurs following bone drilling and ESWT, 50 male Wistar rats were evaluated. The animals were divided into two groups, both of which were subjected to bone drilling. One of the groups was treated with ESWT. The rats were sacrificed on the 3rd, 7th, 14th, 21st, and 28th day. GAG presence was analyzed by agarose gel electrophoresis with subsequent densitometry and ELISA.
  
  
  CONCLUSIONS
  The content of sulfated GAGs increased significantly from the 3rd to the 28th day (p = 0.002). Chondroitin sulfate was expressed more highly than the other GAGs. HA content increased significantly at the 3rd day in animals treated with ESWT compared to the control group (p = 0.003).
  
  
  CONCLUSIONS
  ESWT stimulates of sulfated glycosaminoglycans during bone healing and enhanced early expression of HA compared to the control group.
authors.affiliation: Department of Orthopaedics Surgery, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil. Electronic address: prds@uol.com.br.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Dias dos Santos
authors.affiliation: Department of Biochemistry, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Valquiria Pereira
authors.initials: VP
authors.lastname: De Medeiros
authors.affiliation: Department of Orthopaedics Surgery, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Freire Martins de Moura
authors.affiliation: Department of Orthopaedics Surgery, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: da Silveira Franciozi
authors.affiliation: Department of Biochemistry, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Helena Bonciani
authors.initials: HB
authors.lastname: Nader
authors.affiliation: Department of Orthopaedics Surgery, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Faloppa
mesh_terms: D000818:Animals; D006025:Glycosaminoglycans / Q000378:metabolism*; D019220:High-Energy Shock Waves; D006820:Hyaluronic Acid / Q000378:metabolism*; D008297:Male; D010012:Osteogenesis; D017208:Rats, Wistar
chemical_list: D006025:Glycosaminoglycans; D006820:Hyaluronic Acid
keywords: Bone fractures therapy; Glycosaminoglycans; High energy shock wave; Osteogenesis