Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model: A Dose-Response Study
Background: Tendon–bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on del...
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| Veröffentlicht in: | The American journal of sports medicine 2012-12, Vol.40 (12), p.2862-2871 |
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| creator | Chow, Dick Ho Kiu Suen, Pui Kit Fu, Lai Hong Cheung, Wing Hoi Leung, Kwok Sui Wong, Margaret Wan Nar Qin, Ling |
| description | Background:
Tendon–bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on delayed TBI healing is lacking.
Hypothesis:
Low-dose ESW might have a healing enhancement effect comparable to that of high-dose ESW in treating delayed TBI healing.
Study Design:
Controlled laboratory study.
Methods:
Partial patellectomy was adopted to create a delayed TBI healing model by shielding the healing interface between tendon and bone. Ninety-six female New Zealand White rabbits with unilateral delayed TBI healing at the knee joint were divided into 3 groups: controls, low-dose ESW (LD-ESW; 0.06 mJ/mm2, 4 Hz, 1500 impulses), and high-dose ESW (HD-ESW; 0.43 mJ/mm2, 4 Hz, 1500 impulses). The TBI shielding was removed at week 4 after partial patellectomy, followed by treatment with control or ESW at week 6. The rabbits were euthanized at week 8 and week 12 for radiological, microarchitectural, histological, and mechanical assessments of healing tissues.
Results:
Radiologically, both the LD-ESW group and the HD-ESW group showed larger new bone area than the controls at week 8 and week 12. Microarchitectural measurements showed that the LD-ESW and HD-ESW groups had larger new bone volume than the controls at week 12. Histological assessments confirmed osteogenesis enhancement. Both the LD-ESW and HD-ESW groups showed significantly higher failure load at the TBI healing complex than the control group at week 12. No significant difference was detected between the 2 ESW treatment groups at week 8 or week 12.
Conclusion:
Extracorporeal shockwave, a unique noninvasive physical modality, had similar effects between the low and high dose for treating delayed TBI healing.
Clinical Relevance:
Low-dose ESW for TBI delayed healing might be more desirable and have better compliance in clinical applications. |
| doi_str_mv | 10.1177/0363546512461596 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1221129362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546512461596</sage_id><sourcerecordid>1221129362</sourcerecordid><originalsourceid>FETCH-LOGICAL-c348t-79b269ed648990344347df6fadff2e1d98b1b624b6384db68670634fc8d57ffe3</originalsourceid><addsrcrecordid>eNp10U1PGzEQBmCrApWU9t5TZQkh9bLU3_YegfIlgSq16XnlXY9hYWMHe0Obf1-HhIKQOPkwz7wezSD0mZIDSrX-RrjiUihJmVBU1uodmlApWcW5kltosipXq_oO-pDzLSGEamXeox3GiZaG8AnqT_6OyXYxzWMCO-BfN7G7-2MfAE9vINn5EvuY8LTUxhmEEUePv8Ngl-DwFIKLoTqKAfBFyJDGPgZ8XlL6cI37gC3-adu2H_FVdDB8RNveDhk-bd5d9Pv0ZHp8Xl3-OLs4PrysOi7MWOm6ZaoGp4Spa8KF4EI7r7x13jOgrjYtbRUTreJGuFYZpYniwnfGSe098F30dZ07T_F-AXlsZn3uYBhsgLjIDWWMUlZzxQrde0Vv4yKFMt2jqoXWRhZF1qpLMecEvpmnfmbTsqGkWZ2heX2G0vJlE7xoZ-D-NzztvYD9DbC5s4NPNnR9fnZKC13yiqvWLttreDHdWx__A3aNmwE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1221947785</pqid></control><display><type>article</type><title>Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model: A Dose-Response Study</title><source>MEDLINE</source><source>SAGE Journals Online</source><source>Alma/SFX Local Collection</source><creator>Chow, Dick Ho Kiu ; Suen, Pui Kit ; Fu, Lai Hong ; Cheung, Wing Hoi ; Leung, Kwok Sui ; Wong, Margaret Wan Nar ; Qin, Ling</creator><creatorcontrib>Chow, Dick Ho Kiu ; Suen, Pui Kit ; Fu, Lai Hong ; Cheung, Wing Hoi ; Leung, Kwok Sui ; Wong, Margaret Wan Nar ; Qin, Ling</creatorcontrib><description>Background:
Tendon–bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on delayed TBI healing is lacking.
Hypothesis:
Low-dose ESW might have a healing enhancement effect comparable to that of high-dose ESW in treating delayed TBI healing.
Study Design:
Controlled laboratory study.
Methods:
Partial patellectomy was adopted to create a delayed TBI healing model by shielding the healing interface between tendon and bone. Ninety-six female New Zealand White rabbits with unilateral delayed TBI healing at the knee joint were divided into 3 groups: controls, low-dose ESW (LD-ESW; 0.06 mJ/mm2, 4 Hz, 1500 impulses), and high-dose ESW (HD-ESW; 0.43 mJ/mm2, 4 Hz, 1500 impulses). The TBI shielding was removed at week 4 after partial patellectomy, followed by treatment with control or ESW at week 6. The rabbits were euthanized at week 8 and week 12 for radiological, microarchitectural, histological, and mechanical assessments of healing tissues.
Results:
Radiologically, both the LD-ESW group and the HD-ESW group showed larger new bone area than the controls at week 8 and week 12. Microarchitectural measurements showed that the LD-ESW and HD-ESW groups had larger new bone volume than the controls at week 12. Histological assessments confirmed osteogenesis enhancement. Both the LD-ESW and HD-ESW groups showed significantly higher failure load at the TBI healing complex than the control group at week 12. No significant difference was detected between the 2 ESW treatment groups at week 8 or week 12.
Conclusion:
Extracorporeal shockwave, a unique noninvasive physical modality, had similar effects between the low and high dose for treating delayed TBI healing.
Clinical Relevance:
Low-dose ESW for TBI delayed healing might be more desirable and have better compliance in clinical applications.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546512461596</identifier><identifier>PMID: 23075803</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Animals ; Biological and medical sciences ; Diseases of the osteoarticular system ; Female ; Fractures ; High-Energy Shock Waves - therapeutic use ; Joints - pathology ; Leg Injuries - diagnostic imaging ; Leg Injuries - pathology ; Leg Injuries - therapy ; Medical sciences ; Medical treatment ; Rabbits ; Radiography ; Radiology ; Tendon Transfer ; Tendons ; Tissues ; Wound Healing</subject><ispartof>The American journal of sports medicine, 2012-12, Vol.40 (12), p.2862-2871</ispartof><rights>2012 The Author(s)</rights><rights>2014 INIST-CNRS</rights><rights>Copyright Sage Publications Ltd. Dec 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c348t-79b269ed648990344347df6fadff2e1d98b1b624b6384db68670634fc8d57ffe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546512461596$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546512461596$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26747651$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23075803$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chow, Dick Ho Kiu</creatorcontrib><creatorcontrib>Suen, Pui Kit</creatorcontrib><creatorcontrib>Fu, Lai Hong</creatorcontrib><creatorcontrib>Cheung, Wing Hoi</creatorcontrib><creatorcontrib>Leung, Kwok Sui</creatorcontrib><creatorcontrib>Wong, Margaret Wan Nar</creatorcontrib><creatorcontrib>Qin, Ling</creatorcontrib><title>Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model: A Dose-Response Study</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Tendon–bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on delayed TBI healing is lacking.
Hypothesis:
Low-dose ESW might have a healing enhancement effect comparable to that of high-dose ESW in treating delayed TBI healing.
Study Design:
Controlled laboratory study.
Methods:
Partial patellectomy was adopted to create a delayed TBI healing model by shielding the healing interface between tendon and bone. Ninety-six female New Zealand White rabbits with unilateral delayed TBI healing at the knee joint were divided into 3 groups: controls, low-dose ESW (LD-ESW; 0.06 mJ/mm2, 4 Hz, 1500 impulses), and high-dose ESW (HD-ESW; 0.43 mJ/mm2, 4 Hz, 1500 impulses). The TBI shielding was removed at week 4 after partial patellectomy, followed by treatment with control or ESW at week 6. The rabbits were euthanized at week 8 and week 12 for radiological, microarchitectural, histological, and mechanical assessments of healing tissues.
Results:
Radiologically, both the LD-ESW group and the HD-ESW group showed larger new bone area than the controls at week 8 and week 12. Microarchitectural measurements showed that the LD-ESW and HD-ESW groups had larger new bone volume than the controls at week 12. Histological assessments confirmed osteogenesis enhancement. Both the LD-ESW and HD-ESW groups showed significantly higher failure load at the TBI healing complex than the control group at week 12. No significant difference was detected between the 2 ESW treatment groups at week 8 or week 12.
Conclusion:
Extracorporeal shockwave, a unique noninvasive physical modality, had similar effects between the low and high dose for treating delayed TBI healing.
Clinical Relevance:
Low-dose ESW for TBI delayed healing might be more desirable and have better compliance in clinical applications.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Fractures</subject><subject>High-Energy Shock Waves - therapeutic use</subject><subject>Joints - pathology</subject><subject>Leg Injuries - diagnostic imaging</subject><subject>Leg Injuries - pathology</subject><subject>Leg Injuries - therapy</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Rabbits</subject><subject>Radiography</subject><subject>Radiology</subject><subject>Tendon Transfer</subject><subject>Tendons</subject><subject>Tissues</subject><subject>Wound Healing</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U1PGzEQBmCrApWU9t5TZQkh9bLU3_YegfIlgSq16XnlXY9hYWMHe0Obf1-HhIKQOPkwz7wezSD0mZIDSrX-RrjiUihJmVBU1uodmlApWcW5kltosipXq_oO-pDzLSGEamXeox3GiZaG8AnqT_6OyXYxzWMCO-BfN7G7-2MfAE9vINn5EvuY8LTUxhmEEUePv8Ngl-DwFIKLoTqKAfBFyJDGPgZ8XlL6cI37gC3-adu2H_FVdDB8RNveDhk-bd5d9Pv0ZHp8Xl3-OLs4PrysOi7MWOm6ZaoGp4Spa8KF4EI7r7x13jOgrjYtbRUTreJGuFYZpYniwnfGSe098F30dZ07T_F-AXlsZn3uYBhsgLjIDWWMUlZzxQrde0Vv4yKFMt2jqoXWRhZF1qpLMecEvpmnfmbTsqGkWZ2heX2G0vJlE7xoZ-D-NzztvYD9DbC5s4NPNnR9fnZKC13yiqvWLttreDHdWx__A3aNmwE</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Chow, Dick Ho Kiu</creator><creator>Suen, Pui Kit</creator><creator>Fu, Lai Hong</creator><creator>Cheung, Wing Hoi</creator><creator>Leung, Kwok Sui</creator><creator>Wong, Margaret Wan Nar</creator><creator>Qin, Ling</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20121201</creationdate><title>Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model</title><author>Chow, Dick Ho Kiu ; Suen, Pui Kit ; Fu, Lai Hong ; Cheung, Wing Hoi ; Leung, Kwok Sui ; Wong, Margaret Wan Nar ; Qin, Ling</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-79b269ed648990344347df6fadff2e1d98b1b624b6384db68670634fc8d57ffe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Fractures</topic><topic>High-Energy Shock Waves - therapeutic use</topic><topic>Joints - pathology</topic><topic>Leg Injuries - diagnostic imaging</topic><topic>Leg Injuries - pathology</topic><topic>Leg Injuries - therapy</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Rabbits</topic><topic>Radiography</topic><topic>Radiology</topic><topic>Tendon Transfer</topic><topic>Tendons</topic><topic>Tissues</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chow, Dick Ho Kiu</creatorcontrib><creatorcontrib>Suen, Pui Kit</creatorcontrib><creatorcontrib>Fu, Lai Hong</creatorcontrib><creatorcontrib>Cheung, Wing Hoi</creatorcontrib><creatorcontrib>Leung, Kwok Sui</creatorcontrib><creatorcontrib>Wong, Margaret Wan Nar</creatorcontrib><creatorcontrib>Qin, Ling</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chow, Dick Ho Kiu</au><au>Suen, Pui Kit</au><au>Fu, Lai Hong</au><au>Cheung, Wing Hoi</au><au>Leung, Kwok Sui</au><au>Wong, Margaret Wan Nar</au><au>Qin, Ling</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model: A Dose-Response Study</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>40</volume><issue>12</issue><spage>2862</spage><epage>2871</epage><pages>2862-2871</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background:
Tendon–bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on delayed TBI healing is lacking.
Hypothesis:
Low-dose ESW might have a healing enhancement effect comparable to that of high-dose ESW in treating delayed TBI healing.
Study Design:
Controlled laboratory study.
Methods:
Partial patellectomy was adopted to create a delayed TBI healing model by shielding the healing interface between tendon and bone. Ninety-six female New Zealand White rabbits with unilateral delayed TBI healing at the knee joint were divided into 3 groups: controls, low-dose ESW (LD-ESW; 0.06 mJ/mm2, 4 Hz, 1500 impulses), and high-dose ESW (HD-ESW; 0.43 mJ/mm2, 4 Hz, 1500 impulses). The TBI shielding was removed at week 4 after partial patellectomy, followed by treatment with control or ESW at week 6. The rabbits were euthanized at week 8 and week 12 for radiological, microarchitectural, histological, and mechanical assessments of healing tissues.
Results:
Radiologically, both the LD-ESW group and the HD-ESW group showed larger new bone area than the controls at week 8 and week 12. Microarchitectural measurements showed that the LD-ESW and HD-ESW groups had larger new bone volume than the controls at week 12. Histological assessments confirmed osteogenesis enhancement. Both the LD-ESW and HD-ESW groups showed significantly higher failure load at the TBI healing complex than the control group at week 12. No significant difference was detected between the 2 ESW treatment groups at week 8 or week 12.
Conclusion:
Extracorporeal shockwave, a unique noninvasive physical modality, had similar effects between the low and high dose for treating delayed TBI healing.
Clinical Relevance:
Low-dose ESW for TBI delayed healing might be more desirable and have better compliance in clinical applications.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>23075803</pmid><doi>10.1177/0363546512461596</doi><tpages>10</tpages></addata></record> |
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| ispartof | The American journal of sports medicine, 2012-12, Vol.40 (12), p.2862-2871 |
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| source | MEDLINE; SAGE Journals Online; Alma/SFX Local Collection |
| subjects | Animals Biological and medical sciences Diseases of the osteoarticular system Female Fractures High-Energy Shock Waves - therapeutic use Joints - pathology Leg Injuries - diagnostic imaging Leg Injuries - pathology Leg Injuries - therapy Medical sciences Medical treatment Rabbits Radiography Radiology Tendon Transfer Tendons Tissues Wound Healing |
| title | Extracorporeal Shockwave Therapy for Treatment of Delayed Tendon-Bone Insertion Healing in a Rabbit Model: A Dose-Response Study |
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