Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study
Background Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the h...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2013-04, Vol.471 (4), p.1159-1165 |
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| creator | Lyon, Roger Liu, Xue Cheng Kubin, Martin Schwab, Joseph |
| description | Background
Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions.
Questions/purposes
We asked whether ESWT would enhance articular cartilage quality, bone and cartilage density, and histopathology of osteochondral lesions compared to nontreated controls in an OCD rabbit model.
Methods
We harvested a 4-mm-diameter plug of the weightbearing osteochondral surface on the medial femoral condyle of each knee in 20 skeletally immature (8-week-old) female rabbits. We placed a piece of acellular collagen-glycosaminoglycan matrix into the cavity and then replaced the plug. Two weeks after surgery, we sedated each rabbit and treated the right knee in a single setting with shock waves: 4000 impulses at 4 Hz and 18 kV. The left knee was a sham control. Ten weeks after surgery, we assessed cartilage morphology of the lesion using a modified Outerbridge Grading System, bone and cartilage density using histologic imaging, bone and cartilage morphology using the histopathology assessment system, and radiographic bone density and union and compared these parameters between ESWT-treated and control knees.
Results
Histologically, we observed more mature bone formation and better healing (1.1 versus 3.4) and density of the cartilage (60 versus 49) on the treated side. Radiographically, we noted an increase in bony density (154 versus 138) after ESWT.
Conclusions
ESWT accelerated the healing rate and improved cartilage and subchondral bone quality in the OCD rabbit model.
Clinical Relevance
This therapeutic modality may be applicable in OCD treatment in the pediatric population. Future research will be necessary to determine whether it may play a role in healing of human osteochondral defects. |
| doi_str_mv | 10.1007/s11999-012-2410-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3586044</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2912811661</sourcerecordid><originalsourceid>FETCH-LOGICAL-c499t-9012cc811664f3c13916e782e74a6c2772df8011aa0be777e4c468c4a73326453</originalsourceid><addsrcrecordid>eNqNkk9vEzEQxVcIREPhA3BBlrhwWfB4_ZcDqGpTiqhURIvgZjnOJLtlYwd7N2q-PY5SqoKExMmy3m_e-I2nqp4DfQ2UqjcZwBhTU2A140Br_aCagGC6BmjYw2pCKTW1YfD9oHqS83W5Nlywx9UBY1IaIWBSbU4iZjK9GZLzMa1jQteTyzb6H-Sb2yC5ajG59ZZMQ-uCR3JW9C4sSVyQizxg9G0M89QNXSYnXc7oXcg7cWiRfHGzWTeQTwHx_VtyRD53fRzI5TDOt0-rRwvXZ3x2ex5WX0-nV8dn9fnFh4_HR-e158YMtSnRvNcAUvJF46ExIFFphoo76ZlSbL7QFMA5OkOlFHLPpfbcqaZhkovmsHq3912PsxXOPYYStLfr1K1c2troOvunErrWLuPGNkJLynkxeHVrkOLPEfNgV1322PcuYByzhUYwppkU8j9Q4Ipyo5uCvvwLvY5jCmUSO0qI0lipQsGe8inmnHBx926gdrcAdr8AtkzJ7hbA6lLz4n7gu4rfP14AtgdykcIS073W_3T9BSNHum0</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1315544377</pqid></control><display><type>article</type><title>Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Lyon, Roger ; Liu, Xue Cheng ; Kubin, Martin ; Schwab, Joseph</creator><creatorcontrib>Lyon, Roger ; Liu, Xue Cheng ; Kubin, Martin ; Schwab, Joseph</creatorcontrib><description>Background
Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions.
Questions/purposes
We asked whether ESWT would enhance articular cartilage quality, bone and cartilage density, and histopathology of osteochondral lesions compared to nontreated controls in an OCD rabbit model.
Methods
We harvested a 4-mm-diameter plug of the weightbearing osteochondral surface on the medial femoral condyle of each knee in 20 skeletally immature (8-week-old) female rabbits. We placed a piece of acellular collagen-glycosaminoglycan matrix into the cavity and then replaced the plug. Two weeks after surgery, we sedated each rabbit and treated the right knee in a single setting with shock waves: 4000 impulses at 4 Hz and 18 kV. The left knee was a sham control. Ten weeks after surgery, we assessed cartilage morphology of the lesion using a modified Outerbridge Grading System, bone and cartilage density using histologic imaging, bone and cartilage morphology using the histopathology assessment system, and radiographic bone density and union and compared these parameters between ESWT-treated and control knees.
Results
Histologically, we observed more mature bone formation and better healing (1.1 versus 3.4) and density of the cartilage (60 versus 49) on the treated side. Radiographically, we noted an increase in bony density (154 versus 138) after ESWT.
Conclusions
ESWT accelerated the healing rate and improved cartilage and subchondral bone quality in the OCD rabbit model.
Clinical Relevance
This therapeutic modality may be applicable in OCD treatment in the pediatric population. Future research will be necessary to determine whether it may play a role in healing of human osteochondral defects.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-012-2410-8</identifier><identifier>PMID: 22669551</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Animals ; Bone Density ; Bone Regeneration ; Cartilage, Articular ; Conservative Orthopedics ; Disease Models, Animal ; High-Energy Shock Waves - therapeutic use ; Knee ; Knee Joint ; Male ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteochondritis Dissecans - therapy ; Pilot Projects ; Rabbits ; Sports Medicine ; Statistics, Nonparametric ; Surgery ; Surgical Orthopedics ; Symposium: Osteochondritis Dissecans ; Ultrasonic Therapy - methods ; Wound Healing - physiology</subject><ispartof>Clinical orthopaedics and related research, 2013-04, Vol.471 (4), p.1159-1165</ispartof><rights>The Association of Bone and Joint Surgeons® 2012</rights><rights>The Association of Bone and Joint Surgeons 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-9012cc811664f3c13916e782e74a6c2772df8011aa0be777e4c468c4a73326453</citedby><cites>FETCH-LOGICAL-c499t-9012cc811664f3c13916e782e74a6c2772df8011aa0be777e4c468c4a73326453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586044/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586044/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22669551$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lyon, Roger</creatorcontrib><creatorcontrib>Liu, Xue Cheng</creatorcontrib><creatorcontrib>Kubin, Martin</creatorcontrib><creatorcontrib>Schwab, Joseph</creatorcontrib><title>Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions.
Questions/purposes
We asked whether ESWT would enhance articular cartilage quality, bone and cartilage density, and histopathology of osteochondral lesions compared to nontreated controls in an OCD rabbit model.
Methods
We harvested a 4-mm-diameter plug of the weightbearing osteochondral surface on the medial femoral condyle of each knee in 20 skeletally immature (8-week-old) female rabbits. We placed a piece of acellular collagen-glycosaminoglycan matrix into the cavity and then replaced the plug. Two weeks after surgery, we sedated each rabbit and treated the right knee in a single setting with shock waves: 4000 impulses at 4 Hz and 18 kV. The left knee was a sham control. Ten weeks after surgery, we assessed cartilage morphology of the lesion using a modified Outerbridge Grading System, bone and cartilage density using histologic imaging, bone and cartilage morphology using the histopathology assessment system, and radiographic bone density and union and compared these parameters between ESWT-treated and control knees.
Results
Histologically, we observed more mature bone formation and better healing (1.1 versus 3.4) and density of the cartilage (60 versus 49) on the treated side. Radiographically, we noted an increase in bony density (154 versus 138) after ESWT.
Conclusions
ESWT accelerated the healing rate and improved cartilage and subchondral bone quality in the OCD rabbit model.
Clinical Relevance
This therapeutic modality may be applicable in OCD treatment in the pediatric population. Future research will be necessary to determine whether it may play a role in healing of human osteochondral defects.</description><subject>Animals</subject><subject>Bone Density</subject><subject>Bone Regeneration</subject><subject>Cartilage, Articular</subject><subject>Conservative Orthopedics</subject><subject>Disease Models, Animal</subject><subject>High-Energy Shock Waves - therapeutic use</subject><subject>Knee</subject><subject>Knee Joint</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteochondritis Dissecans - therapy</subject><subject>Pilot Projects</subject><subject>Rabbits</subject><subject>Sports Medicine</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Symposium: Osteochondritis Dissecans</subject><subject>Ultrasonic Therapy - methods</subject><subject>Wound Healing - physiology</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkk9vEzEQxVcIREPhA3BBlrhwWfB4_ZcDqGpTiqhURIvgZjnOJLtlYwd7N2q-PY5SqoKExMmy3m_e-I2nqp4DfQ2UqjcZwBhTU2A140Br_aCagGC6BmjYw2pCKTW1YfD9oHqS83W5Nlywx9UBY1IaIWBSbU4iZjK9GZLzMa1jQteTyzb6H-Sb2yC5ajG59ZZMQ-uCR3JW9C4sSVyQizxg9G0M89QNXSYnXc7oXcg7cWiRfHGzWTeQTwHx_VtyRD53fRzI5TDOt0-rRwvXZ3x2ex5WX0-nV8dn9fnFh4_HR-e158YMtSnRvNcAUvJF46ExIFFphoo76ZlSbL7QFMA5OkOlFHLPpfbcqaZhkovmsHq3912PsxXOPYYStLfr1K1c2troOvunErrWLuPGNkJLynkxeHVrkOLPEfNgV1322PcuYByzhUYwppkU8j9Q4Ipyo5uCvvwLvY5jCmUSO0qI0lipQsGe8inmnHBx926gdrcAdr8AtkzJ7hbA6lLz4n7gu4rfP14AtgdykcIS073W_3T9BSNHum0</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Lyon, Roger</creator><creator>Liu, Xue Cheng</creator><creator>Kubin, Martin</creator><creator>Schwab, Joseph</creator><general>Springer-Verlag</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><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>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130401</creationdate><title>Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study</title><author>Lyon, Roger ; Liu, Xue Cheng ; Kubin, Martin ; Schwab, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-9012cc811664f3c13916e782e74a6c2772df8011aa0be777e4c468c4a73326453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Animals</topic><topic>Bone Density</topic><topic>Bone Regeneration</topic><topic>Cartilage, Articular</topic><topic>Conservative Orthopedics</topic><topic>Disease Models, Animal</topic><topic>High-Energy Shock Waves - therapeutic use</topic><topic>Knee</topic><topic>Knee Joint</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteochondritis Dissecans - therapy</topic><topic>Pilot Projects</topic><topic>Rabbits</topic><topic>Sports Medicine</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Symposium: Osteochondritis Dissecans</topic><topic>Ultrasonic Therapy - methods</topic><topic>Wound Healing - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lyon, Roger</creatorcontrib><creatorcontrib>Liu, Xue Cheng</creatorcontrib><creatorcontrib>Kubin, Martin</creatorcontrib><creatorcontrib>Schwab, Joseph</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lyon, Roger</au><au>Liu, Xue Cheng</au><au>Kubin, Martin</au><au>Schwab, Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>471</volume><issue>4</issue><spage>1159</spage><epage>1165</epage><pages>1159-1165</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><abstract>Background
Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions.
Questions/purposes
We asked whether ESWT would enhance articular cartilage quality, bone and cartilage density, and histopathology of osteochondral lesions compared to nontreated controls in an OCD rabbit model.
Methods
We harvested a 4-mm-diameter plug of the weightbearing osteochondral surface on the medial femoral condyle of each knee in 20 skeletally immature (8-week-old) female rabbits. We placed a piece of acellular collagen-glycosaminoglycan matrix into the cavity and then replaced the plug. Two weeks after surgery, we sedated each rabbit and treated the right knee in a single setting with shock waves: 4000 impulses at 4 Hz and 18 kV. The left knee was a sham control. Ten weeks after surgery, we assessed cartilage morphology of the lesion using a modified Outerbridge Grading System, bone and cartilage density using histologic imaging, bone and cartilage morphology using the histopathology assessment system, and radiographic bone density and union and compared these parameters between ESWT-treated and control knees.
Results
Histologically, we observed more mature bone formation and better healing (1.1 versus 3.4) and density of the cartilage (60 versus 49) on the treated side. Radiographically, we noted an increase in bony density (154 versus 138) after ESWT.
Conclusions
ESWT accelerated the healing rate and improved cartilage and subchondral bone quality in the OCD rabbit model.
Clinical Relevance
This therapeutic modality may be applicable in OCD treatment in the pediatric population. Future research will be necessary to determine whether it may play a role in healing of human osteochondral defects.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22669551</pmid><doi>10.1007/s11999-012-2410-8</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Bone Density Bone Regeneration Cartilage, Articular Conservative Orthopedics Disease Models, Animal High-Energy Shock Waves - therapeutic use Knee Knee Joint Male Medicine Medicine & Public Health Orthopedics Osteochondritis Dissecans - therapy Pilot Projects Rabbits Sports Medicine Statistics, Nonparametric Surgery Surgical Orthopedics Symposium: Osteochondritis Dissecans Ultrasonic Therapy - methods Wound Healing - physiology |
| title | Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study |
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