title: High energy focused shock wave therapy accelerates bone healing. A blinded, prospective, randomized canine clinical trial.
abstract: OBJECTIVE
  To evaluate the influence of shock wave therapy (SWT) on radiographic evidence of bone healing after tibial plateau leveling osteotomy (TPLO).
  
  
  METHODS
  Healthy dogs between two to nine years of age that underwent TPLO were randomly assigned to receive either electro-hydraulic SWT (1,000 shocks) or sham treatment (SHAM). Treatment or SHAM was administered to the osteotomy site immediately postoperatively and two weeks postoperatively. Three blinded radiologists evaluated orthogonal radiographs performed eight weeks postoperatively with both a 5-point and a 10-point bone healing scale. Linear regression analysis was used to compare median healing scores between groups.
  
  
  RESULTS
  Forty-two dogs (50 stifles) were included in the statistical analysis. No major complications were observed and all osteotomies healed uneventfully. The median healing scores were significantly higher at eight weeks postoperatively for the SWT group compared to the SHAM group for the 10-point (p <0.0002) and 5-point scoring systems (p <0.0001).
  
  
  CONCLUSIONS
  Shock wave therapy applied immediately and two weeks postoperatively led to more advanced bone healing at the eight week time point in this study population. The results of this study support the use of electro-hydraulic SWT as a means of accelerating acute bone healing of canine osteotomies. Additional studies are needed to evaluate its use for acceleration of bone healing following fracture, or with delayed union.
authors.forename: N R
authors.initials: NR
authors.lastname: Kieves
authors.forename: C S
authors.initials: CS
authors.lastname: MacKay
authors.forename: K
authors.initials: K
authors.lastname: Adducci
authors.forename: S
authors.initials: S
authors.lastname: Rao
authors.forename: C
authors.initials: C
authors.lastname: Goh
authors.forename: R H
authors.initials: RH
authors.lastname: Palmer
authors.affiliation: Felix Duerr, DVM, MS, DACVS-SA, DECVS, DACVSMR, James L. Voss Veterinary Teaching Hospital, Colorado State University, 300 W. Drake Rd, Fort Collins, CO 80523, United States, Phone: +1 970 297 5000, Fax: +1 970 297 1205, E-mail: Felix.Duerr@colostate.edu.
authors.forename: F M
authors.initials: FM
authors.lastname: Duerr
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D008297:Male; D010027:Osteotomy / Q000662:veterinary*
keywords: Tibial plateau leveling osteotomy; bone healing; canine cruciate disease; shock wave therapy