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Tang P, Wen T, Lu W, Jin H, Pan L, Li H, Zeng B, Zhou Y, Xiao W, Li Y. The efficacy of extracorporeal shock wave therapy for knee osteoarthritis : an umbrella review. Int J Surg 2024; 110:2389-2395. [PMID: 38668665 PMCID: PMC11020044 DOI: 10.1097/js9.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/09/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND An umbrella review was conducted to compare the effectiveness of extracorporeal shock wave therapy (ESWT) versus non-ESWT in the treatment of knee osteoarthritis (KOA). MATERIALS AND METHODS Three databases including PubMed, Embase and Web of science were searched up to September 2023. Literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. Meta-analysis of outcome indicators was performed using Revman 5.4 software. RESULTS A total of eight meta-analysis were included in this umbrella review. All meta-analysis were graded against a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and scored between 8 and 11. Compared to the sham group, the ESWT group showed better results in WOMAC (Western Ontario and McMaster Universities Arthritis Index) [mean difference (MD)=-2.94, 95% CI: -5.52, -0.37, P=0.03, I²=60%], Visual Analog Scale (VAS) (MD=-2.0, 95% CI: -2.5, -1.5, P<0.01, I²=0%), range of motion (ROM) (MD=17.55, 95% CI: 13.49, 21.61, P<0.00001, I²=0%), and Lequesne index (MD=-2.85, 95% CI: -3.64, -2.07, P<0.00001, I²=48%). CONCLUSION Based on the results of our analysis, ESWT is now an effective therapy for improving pain and function in patients with KOA.
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Affiliation(s)
- Peiyuan Tang
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ting Wen
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wenhao Lu
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hongfu Jin
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Linyuan Pan
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hengzhen Li
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Biyun Zeng
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | | | - Wenfeng Xiao
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Li
- Departments ofOrthopedics
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Anderson JR, Johnson E, Jenkins R, Jacobsen S, Green D, Walters M, Bundgaard L, Hausmans BAC, van den Akker G, Welting TJM, Chabronova A, Kharaz YA, Clarke EJ, James V, Peffers MJ. Multi-Omic Temporal Landscape of Plasma and Synovial Fluid-Derived Extracellular Vesicles Using an Experimental Model of Equine Osteoarthritis. Int J Mol Sci 2023; 24:14888. [PMID: 37834337 PMCID: PMC10573509 DOI: 10.3390/ijms241914888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Extracellular vesicles (EVs) contribute to osteoarthritis pathogenesis through their release into joint tissues and synovial fluid. Synovial fluid-derived EVs have the potential to be direct biomarkers in the causal pathway of disease but also enable understanding of their role in disease progression. Utilizing a temporal model of osteoarthritis, we defined the changes in matched synovial fluid and plasma-derived EV small non-coding RNA and protein cargo using sequencing and mass spectrometry. Data exploration included time series clustering, factor analysis and gene enrichment interrogation. Chondrocyte signalling was analysed using luciferase-based transcription factor activity assays. EV protein cargo appears to be more important during osteoarthritis progression than small non-coding RNAs. Cluster analysis revealed plasma-EVs represented a time-dependent response to osteoarthritis induction associated with supramolecular complexes. Clusters for synovial fluid-derived EVs were associated with initial osteoarthritis response and represented immune/inflammatory pathways. Factor analysis for plasma-derived EVs correlated with day post-induction and were primarily composed of proteins modulating lipid metabolism. Synovial fluid-derived EVs factors represented intermediate filament and supramolecular complexes reflecting tissue repair. There was a significant interaction between time and osteoarthritis for CRE, NFkB, SRE, SRF with a trend for osteoarthritis synovial fluid-derived EVs at later time points to have a more pronounced effect.
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Affiliation(s)
- James R. Anderson
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
| | - Emily Johnson
- Computational Biology Facility, Liverpool Shared Research Facilities, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L7 8TX, UK
| | - Rosalind Jenkins
- CDSS Bioanalytical Facility, Liverpool Shared Research Facilities, Department Pharmacology and Therapeutics, University of Liverpool, Liverpool L7 8TX, UK
| | - Stine Jacobsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, DK-1870 Copenhagen, Denmark
| | - Daniel Green
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
| | - Marie Walters
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, DK-1870 Copenhagen, Denmark
| | - Louise Bundgaard
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, DK-1870 Copenhagen, Denmark
| | - Bas A. C. Hausmans
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 Maastricht, The Netherlands; (B.A.C.H.)
| | - Guus van den Akker
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 Maastricht, The Netherlands; (B.A.C.H.)
| | - Tim J. M. Welting
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University, 6229 Maastricht, The Netherlands; (B.A.C.H.)
| | - Alzbeta Chabronova
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
| | - Yalda A. Kharaz
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
| | - Emily J. Clarke
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
| | - Victoria James
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough, Nottingham LE12 5RD, UK
| | - Mandy J. Peffers
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK (Y.A.K.)
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3
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Medina C. Shockwave Therapy in Veterinary Rehabilitation. Vet Clin North Am Small Anim Pract 2023; 53:775-781. [PMID: 36964030 DOI: 10.1016/j.cvsm.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment that involves the transcutaneous delivery of high-energy sound waves into tissue creating therapeutic effects. Shockwaves are nonlinear, high-pressure, high-velocity acoustic waves characterized by low tensile amplitude, short rise time to peak pressure, and a short duration (less than 10 milliseconds). ESWT has been shown to increase the expression of cytokines and growth factors leading to decreased inflammation, neovascularization, and cellular proliferation; activation of osteogenesis by osteoblast differentiation and then by increased proliferation; inhibition of cartilage degeneration and rebuilding of subchondral bone; and increased serotonin in the dorsal horn and descending inhibition of pain signals. Musculoskeletal conditions that can benefit from ESWT include osteoarthritis, tendinopathies, fracture/bone healing, and wound healing.
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Affiliation(s)
- Carolina Medina
- Elanco Animal Health, 2500 Innovation Way, Greenfield, IN 46140, USA.
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4
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Boström A, Bergh A, Hyytiäinen H, Asplund K. Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy. Animals (Basel) 2022; 12:ani12223124. [PMID: 36428352 PMCID: PMC9686741 DOI: 10.3390/ani12223124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/29/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Extracorporeal shockwave therapy (ECSWT) is increasingly used to treat different types of musculoskeletal conditions in sport and companion animals. To explore the scientific basis for the treatment, we conducted a systematic review of the literature on ECSWT used in horses, dogs, and cats. METHODS Relevant articles published in 1980-2020 were identified from three major databases. Each article was assessed for risk of bias. RESULTS The review identified 27 relevant articles on the effects of ECSWT in horses, nine in dogs, but none in cats. Typically, ECSWT involved one to three treatment sessions at 1- to 3-week intervals. We identified studies on bone mass and bone healing, wound healing, navicular disease, ligament injury, desmitis, sesamoiditis, tendon injury, osteoarthritis, and short-term analgesic effects. Common to all indications was that the scientific evidence was very limited. For each separate indication, there were relatively few studies, many of which had methodological flaws. Where favorable results were reported, they were usually not replicated in independent studies. A few encouraging results were found. CONCLUSIONS In sport and companion animals, the scientific evidence for clinical effects of ECSWT in horses, dogs, and cats is limited. For some applications, notably short-term pain relief, ligament ailments, and osteoarthritis, the results seem promising and warrant further exploration in high-quality studies.
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Affiliation(s)
- Anna Boström
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014 Helsinki, Finland
| | - Anna Bergh
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE 750 07 Uppsala, Sweden
- Correspondence:
| | - Heli Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014 Helsinki, Finland
| | - Kjell Asplund
- Department of Public Health and Clinical Medicine, Umeå University, SE 901 87 Umeå, Sweden
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5
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Johnson SA, Richards RB, Frisbie DD, Esselman AM, McClure SR. Equine shock wave therapy ‐ where are we now? Equine Vet J 2022. [DOI: 10.1111/evj.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Sherry A. Johnson
- Department of Clinical Sciences Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | | | - David D. Frisbie
- Department of Clinical Sciences Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - Angie M. Esselman
- Department of Clinical Sciences Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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6
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Anderson JR, Jacobsen S, Walters M, Bundgaard L, Diendorfer A, Hackl M, Clarke EJ, James V, Peffers MJ. Small non-coding RNA landscape of extracellular vesicles from a post-traumatic model of equine osteoarthritis. Front Vet Sci 2022; 9:901269. [PMID: 36003409 PMCID: PMC9393553 DOI: 10.3389/fvets.2022.901269] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/18/2022] [Indexed: 12/12/2022] Open
Abstract
Extracellular vesicles comprise an as yet inadequately investigated intercellular communication pathway in the field of early osteoarthritis. We hypothesised that the small non-coding RNA expression pattern in synovial fluid and plasma would change during progression of experimental osteoarthritis. In this study, we conducted small RNA sequencing to provide a comprehensive overview of the temporal expression profiles of small non-coding transcripts carried by extracellular vesicles derived from plasma and synovial fluid for the first time in a posttraumatic model of equine osteoarthritis. Additionally, we characterised synovial fluid and plasma-derived extracellular vesicles with respect to quantity, size, and surface markers. The different temporal expressions of seven microRNAs in plasma and synovial fluid-derived extracellular vesicles, eca-miR-451, eca-miR-25, eca-miR-215, eca-miR-92a, eca-miR-let-7c, eca-miR-486-5p, and eca-miR-23a, and four snoRNAs, U3, snord15, snord46, and snord58, represent potential biomarkers for early osteoarthritis. Bioinformatics analysis of the differentially expressed microRNAs in synovial fluid highlighted that in early osteoarthritis these related to the inhibition of cell cycle, cell cycle progression, DNA damage and cell proliferation as well as increased cell viability and differentiation of stem cells. Plasma and synovial fluid-derived extracellular vesicle small non-coding signatures have been established for the first time in a temporal model of osteoarthritis. These could serve as novel biomarkers for evaluation of osteoarthritis progression or act as potential therapeutic targets.
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Affiliation(s)
- James R. Anderson
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Stine Jacobsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Marie Walters
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Louise Bundgaard
- Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | | | | | - Emily J. Clarke
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Victoria James
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, United Kingdom
| | - Mandy J. Peffers
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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7
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Effect of High-Power Laser Therapy Versus Shock Wave Therapy on Pain and Function in Knee Osteoarthritis Patients: A Randomized Controlled Trial. Photobiomodul Photomed Laser Surg 2022; 40:198-204. [DOI: 10.1089/photob.2021.0136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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8
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Comparison of Extracorporeal Shockwave Therapy with Non-Steroid Anti-Inflammatory Drugs and Intra-Articular Hyaluronic Acid Injection for Early Osteoarthritis of the Knees. Biomedicines 2022; 10:biomedicines10020202. [PMID: 35203417 PMCID: PMC8869751 DOI: 10.3390/biomedicines10020202] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Conservative treatments for early osteoarthritis (OA) of the knee included the use of non-steroid anti-inflammatory drugs (NSAIDs) and intra-articular hyaluronic acid (HA) injection. Recently, several animal studies reported that extracorporeal shockwave therapy (ESWT) demonstrated chondroprotective effects on knee OA. The present study compared the efficacy of oral NSAIDs, HA injection, and noninvasive ESWT for early OA of the knee. Forty-five patients with early knee OA were randomized into three groups. NSAIDs group received celecoxib 200 mg daily for 3 weeks. HA group received intra-articular injection of HA once a week for 3 weeks. ESWT group received ESWT for 3 sessions at bi-weekly interval. All patients were followed up for one year. Evaluations included the visual analogue scale (VAS) score, serum enzyme-linked immunosorbent assay (ELISA), plain radiography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging (MRI). In addition, the functional scores were performed including, WOMAC (Western Ontario and McMaster Universities Arthritis Index) score, KOOS (knee injury and osteoarthritis outcome) score, and IKDC (International Knee Documentation Committee) score. All three groups showed significant improvement in VAS and functional scores as well as in the collected one-year follow-up data after treatments. ESWT group had better pain relief than NSAIDs and HA groups. ESWT group had better therapeutic effects in the functional scores than NSAIDs and HA groups. The bone mineral density (BMD) of proximal tibia is significantly increased after ESWT than others. In the serum ELISA, ESWT inhibited the expression of COMP in knee OA patients as compared with NSAIDs and HA groups. The parameters of MRI showed no significant differences between three groups after treatments. ESWT and intra-articular HA injection showed comparable results than NSAIDs. ESWT was superior in pain relief than HA and NSAIDs. The results demonstrated that ESWT was an effective and alternative therapy than HA and NSAIDs for early osteoarthritis of the knees.
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9
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Colbath AC, Kisiday JD, Phillips JN, Goodrich LR. Can Extracorporeal Shockwave Promote Osteogenesis of Equine Bone Marrow-Derived Mesenchymal Stem Cells In Vitro ?. Stem Cells Dev 2019; 29:110-118. [PMID: 31744386 DOI: 10.1089/scd.2019.0202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Both bone marrow-derived mesenchymal stem cells (BMDMSCs) and extracorporeal shockwave (ESW) have shown promise for enhancing fracture repair. If exposure of BMDMSCs to ESW enhances osteogenic differentiation, these therapies may be combined in vivo or used as a method for preconditioning BMDMSCs. The objective of this study was to determine the effect of ESW on the osteogenic ability of equine BMDMSCs. We hypothesized that ESW would promote osteogenesis evidenced by increased gene expression, alkaline phosphatase (ALPL) expression, slide morphologic score, and protein expression. BMDMSCs were evaluated from six horses. BMDMSCs were culture expanded to passage 3, dissociated, then placed in conical tubes. Treatment cells ("shocked") were exposed to 500 pulses at 0.16 mJ/mm2 energy. Cells were then reseeded and grown in either growth medium or osteogenic medium. Cellular proliferation and trilineage potential were determined. Cellular morphology was scored and cells were harvested at 1, 3, 7, 14, and 21 days for rtPCR gene expression of osteogenic markers [osteonectin (ONT), osteocalcin (OCN), ALPL, collagen type 3 (COL3), and runt-related transcription factor 2 (RUNX2)]. Media supernatants were evaluated for secretion of BMP-2, VEGF, TGFβ, and PGE2 and cellular lysates were evaluated for ALPL production. There was no difference between the proliferative ability of shocked cells versus unshocked cells in either growth medium or osteogenic medium. ALPL production was greater in shocked cells maintained in osteogenic medium versus unshocked cells in osteogenic medium at day 3 (P < 0.005). Independent of media type, ESW caused a decrease in VEGF and TGFβ production at day 3. No significant increases in gene expression were identified by rtPCR. Exposure of BMDMSCs to ESW does not result in negative effects. An initial significant increase in ALPL was detected but no persistent osteogenic effect was observed with cell expansion.
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Affiliation(s)
- Aimee C Colbath
- Large Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, Michigan
| | - John D Kisiday
- C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado
| | - Jennifer N Phillips
- C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado
| | - Laurie R Goodrich
- Orthopedic Research Center at the C. Wayne McIlwraith Translational Medicine Institute, Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
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10
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Li T, Ma J, Zhao T, Gao F, Sun W. Application and efficacy of extracorporeal shockwave treatment for knee osteoarthritis: A systematic review and meta-analysis. Exp Ther Med 2019; 18:2843-2850. [PMID: 31555375 PMCID: PMC6755419 DOI: 10.3892/etm.2019.7897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 07/05/2019] [Indexed: 11/19/2022] Open
Abstract
The increasing aging of the world population is accompanied by a rise in the incidence of knee osteoarthritis (KOA). There has been a growing interest in shockwave treatment for orthopedic diseases, including KOA. In previous trials, extracorporeal shockwave therapy (ESWT) was compared to physical therapy or placebo in the treatment of KOA. However, the efficacy and safety of ESWT for KOA remains disputed. The present meta-analysis assessed the effects of ESWT in KOA. The PubMed, Medline, Embase, Web of Science, Research Gate and the Cochrane Library were searched to identify comparative studies involving ESWT for patients with KOA. The outcome indicators included the visual analog scale (VAS) score, range of motion (ROM), the Lequesne index (LI) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC). In the comparison of the ESWT vs. placebo groups, the primary outcomes included the VAS score and ROM, while the LI was the secondary outcome. In the comparison of the ESWT vs. physical therapy groups, the primary outcomes included the pain score and ROM, while the secondary outcome was the WOMAC index. Relevant data were analyzed using RevMan v5.3. The ESWT group had a lower VAS core, larger ROM and a better LI than the placebo group after 1 month of therapy (P<0.05). Furthermore, at 1 month post-therapy, the ESWT group had a lower VAS score, larger ROM and a better WOMAC than the physical therapy group (P<0.05). The outcomes regarding pain, ROM, LI and WOMAC were significantly different between the two different groups (P<0.05). The present meta-analysis suggested that ESWT may achieve a better therapeutic effect for patients with KOA as compared to physical therapy. However, high-quality trials with large sample sizes are essential to substantiate these results.
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Affiliation(s)
- Tengqi Li
- Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China.,Department of Orthopedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, P.R. China
| | - Jinhui Ma
- Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Tingting Zhao
- Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Fuqiang Gao
- Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Wei Sun
- Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
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11
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A Randomized Controlled Trial on the Effects of Low-Dose Extracorporeal Shockwave Therapy in Patients With Knee Osteoarthritis. Arch Phys Med Rehabil 2019; 100:1695-1702. [PMID: 31194946 DOI: 10.1016/j.apmr.2019.04.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To test the efficacy of low-dose extracorporeal shockwave therapy (ESWT) on osteoarthritis knee pain, lower limb function, and cartilage alteration for patients with knee osteoarthritis. DESIGN Randomized controlled trial with placebo control. SETTING Outpatient physical therapy clinics within a hospital network. PARTICIPANTS Eligible volunteers (N=63) with knee osteoarthritis (Kellgren-Lawrence grade II or III) were randomly assigned to 2 groups. INTERVENTIONS Patients in the experimental group received low-dose ESWT for 4 weeks while those in the placebo group got sham shockwave therapy. Both groups maintained a usual level of home exercise. MAIN OUTCOME MEASURES Knee pain and physical function were measured using a visual analog scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne index at baseline, 5 weeks, and 12 weeks. Cartilage alteration was measured analyzing the transverse relaxation time (T2) mapping. RESULTS The VAS score, WOMAC, and Lequesne index of the ESWT group were significantly better than those of the placebo group at 5 and 12 weeks (P<.05). Both groups showed improvement in pain and disability scores over the 12-week follow-up period (P<.05). In terms of imaging results, there was no significant difference in T2 values between groups during the trial, although T2 values of the ESWT group at 12 weeks significantly increased compared to those at baseline (P=.004). The number and prevalence of adverse effects were similar between the 2 groups, and no serious side effects were found. CONCLUSIONS A 4-week treatment of low-dose ESWT was superior to placebo for pain easement and functional improvement in patients with mild to moderate knee osteoarthritis but had some negative effects on articular cartilage.
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12
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Yocom AF, Bass LD. Review of the application and efficacy of extracorporeal shockwave therapy in equine tendon and ligament injuries. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. F. Yocom
- Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - L. D. Bass
- Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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13
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Arnhold S, Elashry MI, Klymiuk MC, Wenisch S. Biological macromolecules and mesenchymal stem cells: Basic research for regenerative therapies in veterinary medicine. Int J Biol Macromol 2018; 123:889-899. [PMID: 30452985 DOI: 10.1016/j.ijbiomac.2018.11.158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/05/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Stefan Arnhold
- Institute of Veterinary Anatomy-, Histology and -Embryology, University of Giessen, 35392 Giessen, Germany
| | - Mohamed I Elashry
- Institute of Veterinary Anatomy-, Histology and -Embryology, University of Giessen, 35392 Giessen, Germany; Anatomy and Embryology Department, Faculty of Veterinary Medicine, University of Mansoura 35516, Egypt.
| | - Michele C Klymiuk
- Institute of Veterinary Anatomy-, Histology and -Embryology, University of Giessen, 35392 Giessen, Germany
| | - Sabine Wenisch
- Clinic of Small Animals, c/o Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University of Giessen 35392, Giessen, Germany
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14
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Qi H, Jin S, Yin C, Chen L, Sun L, Liu Y. Radial extracorporeal shock wave therapy promotes osteochondral regeneration of knee joints in rabbits. Exp Ther Med 2018; 16:3478-3484. [PMID: 30233698 PMCID: PMC6143895 DOI: 10.3892/etm.2018.6631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 07/06/2018] [Indexed: 12/26/2022] Open
Abstract
Radial extracorporeal shock wave therapy (rESWT) has been proven to be effective for nonunion fractures. It was, thus, hypothesized that it may be used as a supplement therapy to promote osteochondral regeneration when combined with a scaffold previously prepared by our research group. In the present study, to verify this hypothesis, New Zealand white adult rabbits were anaesthetized and divided into three groups, as follows: Untreated control group, in which full-thickness cylindrical osteochondral defects were created without repairing; scaffold group, in which rabbits were implanted with the scaffolds; scaffold plus rESWT group, in which rabbits were implanted with scaffolds and then treated with rESWT at 2 weeks post-surgery. At 6 and 12 weeks after surgery, the animals were sacrificed. Nitric oxide (NO) levels in the synovial cavity of the knee joints were measured by the Griess method. In addition, macroscopic observation and the gross score according to the International Cartilage Repair Society (ICRS) histological scoring system were determined. Histological evaluation was also performed by hematoxylin-eosin and Safranin O/fast green staining. The results demonstrated that both the scaffold and scaffold plus rESWT treatments significantly reduced NO levels in the synovial cavity at 6 weeks after surgery (P<0.05), whereas no significant difference was observed at 12 weeks after surgery. The ICRS scores of the scaffold and scaffold plus rESWT groups were significantly higher in comparison with those in the control group (P<0.05), and rESWT further increased these scores at 12 weeks after surgery (P<0.05). Histological results revealed that osteochondral regeneration was improved after treatment with scaffold or scaffold plus rESWT, with the latter displaying better results. These data suggested that rESWT improved the osteochondral regeneration when applied in combination with the scaffold, and that one of the underlying mechanisms may involve the reduction of NO in the synovial fluid. Therefore, rESWT may be a useful treatment for knee osteochondral regeneration.
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Affiliation(s)
- Hui Qi
- Musculoskeletal Tissue Bank, Beijing Jishuitan Hospital, Beijing 100035, P.R. China.,Laboratory of Musculoskeletal Regenerative Medicine, Beijing Institute of Traumatology and Orthopaedics, Beijing 100035, P.R. China
| | - Shaofeng Jin
- Musculoskeletal Tissue Bank, Beijing Jishuitan Hospital, Beijing 100035, P.R. China.,Laboratory of Musculoskeletal Regenerative Medicine, Beijing Institute of Traumatology and Orthopaedics, Beijing 100035, P.R. China
| | - Chunyang Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, P.R. China.,University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Lei Chen
- Musculoskeletal Tissue Bank, Beijing Jishuitan Hospital, Beijing 100035, P.R. China.,Laboratory of Musculoskeletal Regenerative Medicine, Beijing Institute of Traumatology and Orthopaedics, Beijing 100035, P.R. China
| | - Lei Sun
- Musculoskeletal Tissue Bank, Beijing Jishuitan Hospital, Beijing 100035, P.R. China.,Laboratory of Musculoskeletal Regenerative Medicine, Beijing Institute of Traumatology and Orthopaedics, Beijing 100035, P.R. China
| | - Yajun Liu
- Orthopedic Shock Wave Treatment Center, Spine Surgery Department, Beijing Jishuitan Hospital, Beijing 100035, P.R. China
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15
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Management and Rehabilitation of Joint Disease in Sport Horses. Vet Clin North Am Equine Pract 2018; 34:345-358. [DOI: 10.1016/j.cveq.2018.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Gutierrez-Nibeyro SD, McCoy AM, Selberg KT. Recent advances in conservative and surgical treatment options of common equine foot problems. Vet J 2018; 237:9-15. [PMID: 30089549 DOI: 10.1016/j.tvjl.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.
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Affiliation(s)
- S D Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - A M McCoy
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - K T Selberg
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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17
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Cheng JH, Wang CJ, Su SH, Huang CY, Hsu SL. Next-generation sequencing identifies articular cartilage and subchondral bone miRNAs after ESWT on early osteoarthritis knee. Oncotarget 2018; 7:84398-84407. [PMID: 27542282 PMCID: PMC5356668 DOI: 10.18632/oncotarget.11331] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/19/2016] [Indexed: 12/21/2022] Open
Abstract
Extracorporeal shockwave therapy (ESWT) has shown chondroprotective effects on the initiation of the osteoarthritis (OA) changes of the rat knee. This study evaluated 69 significant expressed profiles of microRNA (miRNA) in the articular cartilage and subchondral bone after ESWT. There were 118 target genes identified for miRNAs of interest in articular cartilage and 214 target genes in subchondral bone by next generation sequencing (NGS). In principal component analysis (PCA), the relationships of miRNA expression in bone and cartilage were improved after ESWT. Global functional annotation showed that predicted targets were involved in cartilage development, inflammatory and immune response, ion binding, angiogenesis, cell adhesion, cell cycle, transcription and translation, gene expression, NTP binding, signal transduction, collagen fibril organization, apoptotic process, chondrocyte differentiation, cell differentiation, bone development as well as cell proliferation. The miRNAs profile and the target genes were comprehensively surveyed and compared in articular cartilage and subchondral bone of early OA knee before and after ESWT. Our study represents the direct assessment to date of miRNA expression profiling in early OA articular cartilage and subchondral bone. The results provide insights that could contribute to the development of new biomarkers and therapeutic strategies for OA changes and the treatment with ESWT.
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Affiliation(s)
- Jai-Hong Cheng
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Jen Wang
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shi-Hao Su
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Yiu Huang
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shan-Ling Hsu
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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18
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Lee JK, Lee BY, Shin WY, An MJ, Jung KI, Yoon SR. Effect of Extracorporeal Shockwave Therapy Versus Intra-articular Injections of Hyaluronic Acid for the Treatment of Knee Osteoarthritis. Ann Rehabil Med 2017; 41:828-835. [PMID: 29201822 PMCID: PMC5698670 DOI: 10.5535/arm.2017.41.5.828] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 05/12/2017] [Indexed: 12/17/2022] Open
Abstract
Objective To evaluate and compare the effects and outcomes of extracorporeal shock wave therapy (ESWT) and intra-articular injections of hyaluronic acid (HA) in patients with knee osteoarthritis (OA). Methods Of the 78 patients recruited for the study, 61 patients met the inclusion criteria. The enrolled patients were randomly divided into two groups: the ESWT group and the HA group. The ESWT group underwent 3 sessions of 1,000 shockwave pulses performed on the affected knee with the dosage adjusted to 0.05 mJ/mm2 energy. The HA group was administered intra-articular HA once a week for 3 weeks with a 1-week interval between each treatment. The results were measured with the visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, 40-m fast-paced walk test, and stair-climb test (SCT). A baseline for each test was measured before treatment and then the effects of the treatments were measured by each test at 1 and 3 months after treatment. Results In both groups, the scores of the VAS, WOMAC, Lequesne index, 40-m fast-paced walk test, and SCT were significantly improved in a time-dependent manner (p<0.01). There were no statistically significant differences measured at 1 and 3 months after treatment between the two groups (p>0.05). Conclusion The ESWT can be an alternative treatment to reduce pain and improve physical functions in patients with knee OA.
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Affiliation(s)
- June-Kyung Lee
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Bong-Yeon Lee
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Woo-Yong Shin
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Min-Ji An
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Kwang-Ik Jung
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Seo-Ra Yoon
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
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19
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Yılmaz V, Karadaş Ö, Dandinoğlu T, Umay E, Çakçı A, Tan AK. Efficacy of extracorporeal shockwave therapy and low-intensity pulsed ultrasound in a rat knee osteoarthritis model: A randomized controlled trial. Eur J Rheumatol 2017. [PMID: 28638681 DOI: 10.5152/eurjrheum.2017.160089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aims to assess the efficacy of extracorporeal shockwave therapy (ESWT) and low-intensity pulsed ultrasound (LIPUS) on osteoarthritic rat knees. MATERIAL AND METHODS Twenty-four rats were divided into 3 groups: group 1-control (n=8), group 2-LIPUS (n=8) and group 3-ESWT (n=8). Cartilage degeneration was provided using mono-iodo-asetate (MIA). One milligram of MIA was delivered to the right knees in group 1 and both knees in group 2 and 3. A 0.09% saline solution was delivered to the left knees in group 1 for control. Twenty-four hours after the delivery, ESWT was applied once on the right knees in the group 2 rats to the medial tibia plateu with a 1 Hz frequency and 800 impulses. LIPUS was applied to the right knees in the group 2 rats to the medial tibia plateu with a 3 mHz frequency and 40 mW/cm2 intensity for 20 minutes over a period of 15 days. Pain scores were measured with a knee bend test. Bone mineral density measurements and scintigraphic bone scans were performed. Histopathological examination was done using a modified Mankin scale. RESULTS There was no difference among the right knee subchondral bone osteoblastic activities (p>0.05). The left knee osteoblastic activities in the LIPUS and extracorporeal shockwave therapy (ESWT) groups were higher than those in the control group (p<0.05), but there was no difference between the LIPUS and ESWT groups. There was no difference among the groups for both knee subchondral bone BMD values (p>0.05). The modified Mankin scores of both the right and left knees of the ESWT and LIPUS groups were lower than those of the control group (p<0.05), but there was no difference between the ESWT and LIPUS groups. The pain scores of both knees of the ESWT and LIPUS groups at day 7 were higher than those of the control group (p<0.05), but there was no difference between the ESWT and LIPUS groups. There was no difference among the pain scores of the right knees at day 14 (p<0.05). CONCLUSION ESWT and LIPUS have systemic proliferative and regenerative effects on cartilage and tissue.
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Affiliation(s)
- Volkan Yılmaz
- Physical Rehabilitation Medicine Clinic, S.B Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ömer Karadaş
- Department of Neurology, S.B.Ü Gülhane Training and Research Hospital, Ankara, Turkey
| | - Taner Dandinoğlu
- Department of Physical Rhabilitation Medicine, S.B.Ü Gülhane Training and Research Hospital Ankara, Turkey
| | - Ebru Umay
- Physical Rehabilitation Medicine Clinic, S.B Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Aytül Çakçı
- Physical Rehabilitation Medicine Clinic, S.B Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Arif Kenan Tan
- Department of Physical Rhabilitation Medicine, S.B.Ü Gülhane Training and Research Hospital Ankara, Turkey
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20
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Colbath AC, Frisbie DD, Dow SW, Kisiday JD, McIlwraith CW, Goodrich LR. Equine Models for the Investigation of Mesenchymal Stem Cell Therapies in Orthopaedic Disease. OPER TECHN SPORT MED 2017. [DOI: 10.1053/j.otsm.2016.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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21
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Hsu SL, Cheng JH, Wang CJ, Ko JY, Hsu CH. Extracorporeal Shockwave Therapy Enhances Expression of Pdia-3 Which Is a Key Factor of the 1α,25-Dihydroxyvitamin D 3 Rapid Membrane Signaling Pathway in Treatment of Early Osteoarthritis of the Knee. Int J Med Sci 2017; 14:1220-1230. [PMID: 29104478 PMCID: PMC5666555 DOI: 10.7150/ijms.20303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/05/2017] [Indexed: 11/17/2022] Open
Abstract
The goal of our research was demonstrated that multiple molecules in microenvironments of the early osteoarthritis (OA) joint tissue may be actively responded to extracorporeal shockwave therapy (ESWT) treatment, which potentially regulated biological function of chondrocytes and synovial cells in early OA knee. We demonstrated that shockwave treatment induced the expression of protein-disulfide isomerase-associated 3 (Pdia-3) which was a significant mediator of the 1α,25-Dihydroxyvitamin D 3 (1α,25(OH)2D3) rapid signaling pathway, using two-dimensional electrophoresis, histological analysis and quantitative polymerase chain reaction (qPCR). We observed that the expression of Pdia-3 at 2 weeks was significantly higher than that of other group at 4, 8, and 12 weeks post-shockwave treatment in early OA rat knee model. The other factors of the rapid membrane signaling pathway, including extracellular signal-regulated protein kinases 1 (ERK1), osteopontin (OPG), alkaline phosphatase (ALP), and matrix metallopeptidase 13 (MMP13) were examined and were found to be significantly increased at 2 weeks post-shockwave treatment by qPCR in early OA of the knee. Our proteomic data revealed significant Pdia-3 expression in microenvironments of OA joint tissue that could be actively responded to ESWT, which may potentially regulate the biological functions of chondrocytes and osteoblasts in the treatment of the early OA of the knee.
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Affiliation(s)
- Shan-Ling Hsu
- Center for Shockwave Medicine and Tissue Engineering.,Department of Orthopedic Surgery
| | - Jai-Hong Cheng
- Center for Shockwave Medicine and Tissue Engineering.,Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Jen Wang
- Center for Shockwave Medicine and Tissue Engineering.,Department of Orthopedic Surgery
| | - Jih-Yang Ko
- Center for Shockwave Medicine and Tissue Engineering.,Department of Orthopedic Surgery
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22
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Wang CJ, Cheng JH, Chou WY, Hsu SL, Chen JH, Huang CY. Changes of articular cartilage and subchondral bone after extracorporeal shockwave therapy in osteoarthritis of the knee. Int J Med Sci 2017; 14:213-223. [PMID: 28367081 PMCID: PMC5370283 DOI: 10.7150/ijms.17469] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/21/2016] [Indexed: 11/22/2022] Open
Abstract
We assessed the pathological changes of articular cartilage and subchondral bone on different locations of the knee after extracorporeal shockwave therapy (ESWT) in early osteoarthritis (OA). Rat knees under OA model by anterior cruciate ligament transaction (ACLT) and medial meniscectomy (MM) to induce OA changes. Among ESWT groups, ESWT were applied to medial (M) femur (F) and tibia (T) condyles was better than medial tibia condyle, medial femur condyle as well as medial and lateral (L) tibia condyles in gross osteoarthritic areas (p<0.05), osteophyte formation and subchondral sclerotic bone (p<0.05). Using sectional cartilage area, modified Mankin scoring system as well as thickness of calcified and un-calcified cartilage analysis, the results showed that articular cartilage damage was ameliorated and T+F(M) group had the most protection as compared with other locations (p<0.05). Detectable cartilage surface damage and proteoglycan loss were measured and T+F(M) group showed the smallest lesion score among other groups (p<0.05). Micro-CT revealed significantly improved in subchondral bone repair in all ESWT groups compared to OA group (p<0.05). There were no significantly differences in bone remodeling after ESWT groups except F(M) group. In the immunohistochemical analysis, T+F(M) group significant reduced TUNEL activity, promoted cartilage proliferation by observation of PCNA marker and reduced vascular invasion through observation of CD31 marker for angiogenesis compared to OA group (P<0.001). Overall the data suggested that the order of the effective site of ESWT was T+F(M) ≧ T(M) > T(M+L) > F(M) in OA rat knees.
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Affiliation(s)
- Ching-Jen Wang
- Center for Shockwave Medicine and Tissue Engineering;; Department of Orthopedic Surgery, Section of Sports Medicine
| | | | - Wen-Yi Chou
- Department of Orthopedic Surgery, Section of Sports Medicine
| | - Shan-Ling Hsu
- Center for Shockwave Medicine and Tissue Engineering;; Department of Orthopedic Surgery, Section of Sports Medicine
| | - Jen-Hung Chen
- Department of Orthopedic Surgery, Section of Sports Medicine
| | - Chien-Yiu Huang
- Center for Shockwave Medicine and Tissue Engineering;; Department of Orthopedic Surgery, Section of Sports Medicine
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23
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Daglish J, Mama KR. Pain: Its Diagnosis and Management in the Rehabilitation of Horses. Vet Clin North Am Equine Pract 2016; 32:13-29. [PMID: 27012506 DOI: 10.1016/j.cveq.2015.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This article provides a brief overview of pain physiology and its relevance to equine patients. Objective and subjective techniques for assessing pain in the horse are described in depth. Pharmacologic and interventional pain modulation treatments are discussed with a focus on the rehabilitating horse.
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Affiliation(s)
- Jodie Daglish
- Equine Sports Medicine and Rehabilitation, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Khursheed R Mama
- Veterinary, Anesthesiology, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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24
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Schlachter C, Lewis C. Electrophysical Therapies for the Equine Athlete. Vet Clin North Am Equine Pract 2016; 32:127-47. [PMID: 27012509 DOI: 10.1016/j.cveq.2015.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A good rehabilitation program takes into account the possible causes for the injury. Once the underlying cause of the injury is determined, a veterinarian can construct an appropriate rehabilitation plan and use the available electrophysical therapies to their greatest effect. Treating the horse correctly for the type and location of injury, and the stage of rehabilitation of the tissue, helps ensure full rehabilitation success. This article discusses when and how to use the most common electrophysical therapies in horses including transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, functional electric stimulation, pulsed electromagnetic field therapy, therapeutic ultrasound, laser therapy, shockwave therapy, and vibration therapy.
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25
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Cho SJ, Yang JR, Yang HS, Yang HE. Effects of Extracorporeal Shockwave Therapy in Chronic Stroke Patients With Knee Osteoarthritis: A Pilot Study. Ann Rehabil Med 2016; 40:862-870. [PMID: 27847716 PMCID: PMC5108713 DOI: 10.5535/arm.2016.40.5.862] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/02/2016] [Indexed: 11/11/2022] Open
Abstract
Objective To evaluate the effects of extracorporeal shockwave therapy (ESWT) on pain, function, and ultrasonographic features of chronic stroke patients with knee osteoarthritis (OA). Methods A total of 18 chronic stroke patients (33 knee joints) with unilateral or bilateral knee OA (Kellgren-Lawrence grade ≥1) were enrolled in this study. The patients were randomly allocated to an experimental group receiving ESWT (n=9) or a control group receiving sham ESWT (n=9). For the ESWT group, patients received 1,000 pulses weekly for 3 weeks, totaling to an energy dose of 0.05 mJ/mm2 on the proximal medial tibia of the affected knee. The assessments were performed before the treatment, immediately after the first treatment, and 1 week after the last treatment using the following: the visual analog scale (VAS) for pain; patient perception of the clinical severity of OA; the Korean version of Modified Barthel Index (ambulation and chair/bed transfer); the Functional Independence Measure scale (FIM; bed/chair/wheelchair transfer, toilet transfer, walking, and stairs); and ultrasonographic features (articular cartilage thickness, Doppler activity, and joint effusion height). Results The experimental group showed a significant improvement in VAS score (4.50±1.87 to 2.71±1.38) and patient perception of the clinical severity of OA (1.87±0.83 to 2.75±0.46). The bed/chair/wheelchair transfer components of the FIM score also improved significantly (4.12±1.55 to 4.62±1.30). In terms of the ultrasonographic features, increased Doppler activity was observed in the medial knee in the experimental group immediately following ESWT. Conclusion It is suggested that ESWT may reduce pain and improve function in chronic stroke patients with OA, and may increase vascular activity at the target site.
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Affiliation(s)
- Sung Jun Cho
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
| | - Ja Ryung Yang
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
| | - Hee Seung Yang
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
| | - Hea-Eun Yang
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
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26
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Ji Q, Wang P, He C. Extracorporeal shockwave therapy as a novel and potential treatment for degenerative cartilage and bone disease: Osteoarthritis. A qualitative analysis of the literature. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2016; 121:255-65. [PMID: 27423987 DOI: 10.1016/j.pbiomolbio.2016.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/12/2016] [Indexed: 02/05/2023]
Abstract
Osteoarthritis (OA) is characterized with pathological changes on articular cartilage and subchondral bone, with clinical symptoms of pain and motor dysfunction in affected joints. A growing number of investigations demonstrated the therapeutic effects of extracorporeal shockwave therapy (ESWT) on joints with OA. While the partial mechanisms of action are based on cellular mechanotransduction through cytoskeleton into nuclei to regulate gene expression and cause biophysical influences, the efficacy and exact mechanisms are still under exploration. At present, a summary of the evidence regarding effectiveness of ESWT on OA is not available. The purpose of this review is thus to offer an overview of ESWT in the management of OA in the aspects of cartilage, subchondral bone, pain sensation and motor function, in hopes of eliciting further multi-disciplinary scientific investigations into this promising application as an adjunct to other modalities or surgery. The optimal frequencies, impulses, energy intensity and protocols of ESWT in the management of OA continue to be elucidated. Further studies are required to reveal its exact mechanisms and biophysical effects on cells, animals and humans prior to the clinical application.
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Affiliation(s)
- Qiaodan Ji
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China; Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan Province, People's Republic of China
| | - Pu Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China; Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan Province, People's Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China; Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan Province, People's Republic of China.
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27
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Memon MA, Shmalberg J, Adair HS, Allweiler S, Bryan JN, Cantwell S, Carr E, Chrisman C, Egger CM, Greene S, Haussler KK, Hershey B, Holyoak GR, Johnson M, Jeune SL, Looney A, McConnico RS, Medina C, Morton AJ, Munsterman A, Nie GJ, Park N, Parsons-Doherty M, Perdrizet JA, Peyton JL, Raditic D, Ramirez HP, Saik J, Robertson S, Sleeper M, Dyke JV, Wakshlag J. Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges. Open Vet J 2016; 6:44-56. [PMID: 27200270 PMCID: PMC4824037 DOI: 10.4314/ovj.v6i1.7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/04/2016] [Indexed: 12/13/2022] Open
Abstract
Integrative veterinary medicine (IVM) describes the combination of complementary and
alternative therapies with conventional care and is guided by the best available
evidence. Veterinarians frequently encounter questions about complementary and
alternative veterinary medicine (CAVM) in practice, and the general public has
demonstrated increased interest in these areas for both human and animal health.
Consequently, veterinary students should receive adequate exposure to the principles,
theories, and current knowledge supporting or refuting such techniques. A proposed
curriculum guideline would broadly introduce students to the objective evaluation of
new veterinary treatments while increasing their preparation for responding to
questions about IVM in clinical practice. Such a course should be evidence-based,
unbiased, and unaffiliated with any particular CAVM advocacy or training group. All
IVM courses require routine updating as new information becomes available.
Controversies regarding IVM and CAVM must be addressed within the course and
throughout the entire curriculum. Instructional honesty regarding the uncertainties
in this emerging field is critical. Increased training of future veterinary
professionals in IVM may produce an openness to new ideas that characterizes the
scientific method and a willingness to pursue and incorporate evidence-based medicine
in clinical practice with all therapies, including those presently regarded as
integrative, complementary, or alternative.
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Affiliation(s)
- M A Memon
- Department of Clinical Science, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - J Shmalberg
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - H S Adair
- Department of Small Animal Clinical Sciences (Egger) and Department of Large Animal Clinical Sciences (Adair), College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - S Allweiler
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - J N Bryan
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - S Cantwell
- Medicine Wheel Veterinary Services, Ocala, FL, USA
| | - E Carr
- Department of Small Animal Clinical Sciences (Robertson) and Department of Large Animal Clinical Sciences (Carr), College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - C Chrisman
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - C M Egger
- Department of Small Animal Clinical Sciences (Egger) and Department of Large Animal Clinical Sciences (Adair), College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - S Greene
- Department of Clinical Science, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - K K Haussler
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - B Hershey
- Integrative Veterinary Oncology, Phoenix, AZ, USA
| | - G R Holyoak
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - M Johnson
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - S Le Jeune
- Veterinary Medical Teaching Hospital (Peyton) and Department of Surgical and Radiological Sciences (Le Jeune), School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - R S McConnico
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - C Medina
- Coral Springs Animal Hospital, Coral Springs, FL, USA
| | - A J Morton
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - A Munsterman
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - G J Nie
- Angel Animal Hospital, Springfield, MO, USA
| | - N Park
- Integrative Ophthalmology for Pets, Los Angeles, CA, USA
| | | | | | - J L Peyton
- Veterinary Medical Teaching Hospital (Peyton) and Department of Surgical and Radiological Sciences (Le Jeune), School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - H P Ramirez
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - J Saik
- Winterville Animal Clinic, Winterville, GA, USA
| | - S Robertson
- Department of Small Animal Clinical Sciences (Robertson) and Department of Large Animal Clinical Sciences (Carr), College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - M Sleeper
- Departments of Small Animal Clinical Sciences (Shmalberg, Chrisman, Johnson, Sleeper), Large Animal Clinical Sciences (Morton), and Biomedical Sciences (Ramirez), College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - J Van Dyke
- Canine Rehabilitation Institute, Wellington, FL, USA
| | - J Wakshlag
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Kaneps AJ. Practical Rehabilitation and Physical Therapy for the General Equine Practitioner. Vet Clin North Am Equine Pract 2016; 32:167-80. [PMID: 26898959 DOI: 10.1016/j.cveq.2015.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Physical treatment and rehabilitation play major roles in recovery and maintenance of the equine athlete, and many therapeutic measures are accessible by the veterinarian in general practice. An accurate diagnosis of the condition undergoing treatment is a requirement, and measurable parameters obtained at diagnosis allows for quantification of treatment outcomes. Therapeutic modalities accessible to the general practicing veterinarian are reviewed. Mechanisms of action, indications, and treatment protocols of thermal therapy, therapeutic ultrasound, extracorporeal shock wave, and laser are discussed. Manipulative therapies, including stretching and use of core strengthening exercises and equipment, are outlined.
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Affiliation(s)
- Andris J Kaneps
- Kaneps Equine Sports Medicine and Surgery, LLC, 68 Grover Street, Beverly, MA 01915, USA.
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Chen JW, Uboh CE, Robinson MA, Jiang Z, Soma LR. Plasma interleukin-6 concentration in Standardbred racehorses determined by means of a novel validated ELISA. Am J Vet Res 2016; 77:13-23. [DOI: 10.2460/ajvr.77.1.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kim JH, Kim JY, Choi CM, Lee JK, Kee HS, Jung KI, Yoon SR. The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis. Ann Rehabil Med 2015; 39:616-23. [PMID: 26361599 PMCID: PMC4564710 DOI: 10.5535/arm.2015.39.4.616] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/10/2015] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) for knee osteoarthritis. Methods Seventy-five subjects were recruited, 60 of which met the inclusion criteria. The patients were randomly classified into two groups: group L, which was a low-energy group (n=30; 1,000 shocks/session; energy flux density [EFD], 0.040 mJ/mm2) and group M, which was a medium-energy group (n=30; 1,000 shocks/session; EFD, 0.093 mJ/mm2). For each group, 1,000 shock waves were delivered to the medial tibial plateau area, once a week, for 3 weeks. The main outcome measures were the visual analogue scale (VAS), the Roles and Maudsley (RM) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Lequesne index. Each assessment was performed at the baseline and at 1, 4, and 12 weeks after ESWT. Results In both groups, the VAS, the RM and WOMAC scores, and the Lequesne index were significantly improved over time (p<0.001), and group M showed greater improvement over group L at the 1, 4 and 12 weeks assessments. Conclusion In this study, medium-energy group (group M) showed greater improvement in regard to relieving pain and restoring functional outcome than the low-energy group (group L). Therefore, EFD can be considered to have significant influence when treating with ESWT for knee osteoarthritis.
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Affiliation(s)
- Jin-Hong Kim
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Ja-Young Kim
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Cheol-Min Choi
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - June-Kyung Lee
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Hoi-Sung Kee
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Kwang-Ik Jung
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
| | - Seo-Ra Yoon
- Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea
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McIlwraith CW. Management of joint diseases in horses: Current and future prospects. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center; Colorado State University; Fort Collins Colorado USA
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Koenig TJ, Dart AJ, McIlwraith CW, Horadagoda N, Bell RJ, Perkins N, Dart C, Krockenberger M, Jeffcott LB, Little CB. Treatment of experimentally induced osteoarthritis in horses using an intravenous combination of sodium pentosan polysulfate, N-acetyl glucosamine, and sodium hyaluronan. Vet Surg 2014; 43:612-22. [PMID: 24819506 DOI: 10.1111/j.1532-950x.2014.12203.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 03/01/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the effects of sodium pentosan polysulfate (PPS), N-acetyl glucosamine (NAG), and sodium hyaluronan (HA) in horses with induced osteoarthritis (OA). STUDY DESIGN Experimental. ANIMALS Adult Standard bred horses (n = 16). METHODS OA was induced arthroscopically in 1 intercarpal joint; 8 horses were administered 3 mg/kg PPS, 4.8 mg/kg NAG, and 0.12 mg/kg HA (PGH), intravenously (IV), weekly and 8 horses were administered an equivalent volume of saline IV until study completion (day 70). Horses underwent a standardized treadmill exercise program. Clinical and radiographic findings and synovial fluid analysis were evaluated throughout the study. Macroscopic, histologic, histochemical, and biochemical findings were evaluated after necropsy. Comparisons of interest included OA and non-OA joints of saline treated horses and OA joints of PGH treated horses and OA joints of saline treated horses. Results were statistically analyzed with significance set at P < .05. RESULTS OA caused increases in clinical assessment scores, synovial fluid variables, radiographic, macroscopic, and histologic cartilage scores, synovial fluid and cartilage chondroitin sulfate 846-epitope and glycosaminoglycan concentration. Total radiographic scores, total macroscopic joint pathology and macroscopic cartilage pathology scores were significantly reduced in horses treated with PGH compared with saline treated horses. Synovial fluid total protein concentration and white blood cell count were higher in OA joints of PGH treated horses compared with saline treated horses. There were no other significant differences between treatment groups. CONCLUSIONS Improvements in macroscopic variables were not supported by other outcomes. Further evidence is needed before PGH can be recommended as a therapeutic option for osteoarthritis in horses.
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Affiliation(s)
- Toby J Koenig
- Research and Clinical Training Unit, University Veterinary Teaching Hospital Camden, Faculty of Veterinary Science, University of Sydney, Camden, Australia
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Zhao Z, Jing R, Shi Z, Zhao B, Ai Q, Xing G. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. J Surg Res 2013; 185:661-6. [DOI: 10.1016/j.jss.2013.07.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/29/2013] [Accepted: 07/03/2013] [Indexed: 11/30/2022]
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Frisbie D, McIlwraith C, Kawcak C, Werpy N. Evaluation of intra-articular hyaluronan, sodium chondroitin sulfate and N-acetyl-d-glucosamine combination versus saline (0.9% NaCl) for osteoarthritis using an equine model. Vet J 2013; 197:824-9. [DOI: 10.1016/j.tvjl.2013.05.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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Effects of intraarticular treatment with stanozolol on synovial membrane and cartilage in an ovine model of osteoarthritis. Res Vet Sci 2013; 94:379-87. [DOI: 10.1016/j.rvsc.2012.11.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 11/05/2012] [Accepted: 11/17/2012] [Indexed: 11/20/2022]
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Wang CJ, Sun YC, Siu KK, Wu CT. Extracorporeal shockwave therapy shows site-specific effects in osteoarthritis of the knee in rats. J Surg Res 2013; 183:612-9. [PMID: 23472862 DOI: 10.1016/j.jss.2013.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/24/2013] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE This study investigated the site-specific effects of extracorporeal shockwave therapy (ESWT) in osteoarthritis of the knee in rats. METHODS Sixty SD rats were divided into five groups. Group I was the control and received sham surgery without anterior cruciate ligament transection (ACLT) and medial meniscectomy (MM) and no ESWT. Group II received ACLT + MM, but no ESWT. Group III received ACLT + MM and ESWT at distal femur. Group IV received ACLT + MM and ESWT at proximal tibia. Group V received ACLT + MM and ESWT at distal femur and proximal tibia. Each ESWT session consisted of 800 impulses at 14 kV (= 0.219 mJ/mm(2) energy flux density). The evaluations included radiograph, bone mineral density (BMD), histomorphologic examination, and immunohistochemical analysis. RESULTS Radiographic appearance: Group II showed progressive osteoarthritis of the knee at 12 and 24 wk, whereas only subtle changes were noted in Groups I, III, VI, and V. BMD results: Group II showed significant decreases of BMD at 12 and 24 wk. The BMDs of Groups III, IV, and V were comparable to Group I. Cartilage degradation: Group II showed significant increases of Mankin score, Safranin O stain, and matrix metalloproteinase 13 and decrease of collagen II at 12 and 24 wk. The changes of Mankin score, Safranin O stain, matrix metalloproteinase 13, and collagen II in Groups III, IV, and V were comparable to Group I. Subchondral bone remodeling: Group II showed significant decreases of vascular endothelial growth factor, bone morphogenetic protein 2, and osteocalcin at 12 and 24 wk as compared to Group I. The changes of vascular endothelial growth factor, bone morphogenetic protein 2, and osteocalcin in Groups III, IV, and V were comparable to Group I. CONCLUSION ESWT shows site-specific effects at distal femur and proximal tibia in osteoarthritis of the knee in rats. The effects of ESWT are consistent at distal femur and proximal tibia, with no additive effects when both areas were simultaneously treated.
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Affiliation(s)
- Ching-Jen Wang
- Department of Orthopedic Surgery, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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Wang CJ, Hsu SL, Weng LH, Sun YC, Wang FS. Extracorporeal shockwave therapy shows a number of treatment related chondroprotective effect in osteoarthritis of the knee in rats. BMC Musculoskelet Disord 2013; 14:44. [PMID: 23356403 PMCID: PMC3626641 DOI: 10.1186/1471-2474-14-44] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 01/24/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Extracorporeal shockwave therapy (ESWT) shows chondroprotective effect in osteoarthritis of the rat knees. However, the ideal number of ESWT is unknown. This study investigated the effects of different numbers of ESWT in osteoarthritis of the knee in rats. METHODS Forty-five male Sprague-Dawley rats were divided into five groups. Group I underwent sham arthrotomy without anterior cruciate ligament transection (ACLT) or medial meniscectomy (MM) and received no ESWT. Group II underwent ACLT + MM and received no ESWT. Group III underwent ACLT + MM, and received ESWT once a week for one treatment. Group IV underwent ACLT + MM and received ESWT twice a week for 2 treatments. Group V underwent ACLT + MM and received ESWT three times a week for 3 treatments. Each treatment consisted of 800 impulses of shockwave at 14 Kv to the medial tibia condyle. The evaluations included radiographs of the knee, histomorphological examination and immunohistochemical analysis at 12 weeks. RESULTS At 12 weeks, group II and V showed more radiographic arthritis than groups I, III and IV. On histomorphological examination, the Safranin O matrix staining in groups III and IV are significantly better than in groups II and V, and the Mankin scores in groups III and IV are less than groups II and V. Groups III and IV showed significant decreases of Mankin score and increase of Safranin O stain as compared to group I. Group V showed significant increases of Mankin score and a decrease of Safranin O stain as compared to group II. In articular cartilage, group II showed significant increase of MMP13 and decrease of collagen II as compared to group I. Groups III and IV showed significant decrease of MMP13 and increase of collagen II as compared to group I. Group V showed significant increase of MMP13 and decrease of collagen II as compared to group II. In subchondral bone, vWF, VEGF, BMP-2 and osteocalcin significantly decreased in groups II and V, but increased in groups III and IV relative to group I. CONCLUSIONS ESWT shows a number of treatment related chondroproctective effect in osteoarthritis of the knee in rats.
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Affiliation(s)
- Ching-Jen Wang
- Department of Orthopedic Surgery, Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shan-Ling Hsu
- Department of Orthopedic Surgery, Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Lin-Hsiu Weng
- Department of Orthopedic Surgery, Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yi-Chih Sun
- Department of Medical Research, Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Feng-Sheng Wang
- Department of Medical Research, Chang Gung University College of Medicine Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Lameness Associated with Mineralization of the Central Tarsal Bone and a Small Osseous Cyst-Like Lesion in Two Sport Horses. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.04.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kamm JL, Frisbie DD, McIlwraith CW, Orr KE. Gene biomarkers in peripheral white blood cells of horses with experimentally induced osteoarthritis. Am J Vet Res 2013; 74:115-21. [DOI: 10.2460/ajvr.74.1.115] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis. Bone Joint Res 2012; 1:297-309. [PMID: 23610661 PMCID: PMC3626203 DOI: 10.1302/2046-3758.111.2000132] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 09/24/2012] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis (OA) is an important cause of
pain, disability and economic loss in humans, and is similarly important in
the horse. Recent knowledge on post-traumatic OA has suggested opportunities
for early intervention, but it is difficult to identify the appropriate
time of these interventions. The horse provides two useful mechanisms
to answer these questions: 1) extensive experience with clinical
OA in horses; and 2) use of a consistently predictable model of
OA that can help study early pathobiological events, define targets
for therapeutic intervention and then test these putative therapies.
This paper summarises the syndromes of clinical OA in horses including
pathogenesis, diagnosis and treatment, and details controlled studies
of various treatment options using an equine model of clinical OA.
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Affiliation(s)
- C W McIlwraith
- Orthopaedic Research Center, Colorado State University, 300 West Drake Road, Fort Collins, Colorado 80523, USA
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Zhao Z, Ji H, Jing R, Liu C, Wang M, Zhai L, Bai X, Xing G. Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis. Arch Orthop Trauma Surg 2012; 132:1547-53. [PMID: 22825641 DOI: 10.1007/s00402-012-1586-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The goal for treating osteoarthritis (OA) is finding ways to decrease joint pain and dysfunction and prevent and slow the cartilage degeneration. Extracorporeal shock-wave therapy (ESWT) has been found to improve motor dysfunction and ameliorate pain with OA in animals. However, few studies have found that it can prevent and slow joint degeneration in vivo. The aim of study was to investigate the effect of ESWT on OA in rabbit. MATERIALS AND METHODS A total of 30 male New Zealand white rabbits were divided into 3 groups: control, OA induced by anterior cruciate ligament transaction (ACLT), and ALCT plus ESWT. The animals were killed at 4 and 8 weeks. Nitric oxide (NO) level was measured in the synovial cavity of knee joints, and cartilage sections were graded macroscopically by a Mankin scoring system. Chondrocyte apoptosis was investigated by flow cytometry and the expression of active caspase 3 by indirect immunohistochemistry. RESULTS ESWT significantly reduced the NO level in the synovial cavity of knee joints (P < 0.05) and chondrocyte apoptosis (P < 0.05) of rabbits with OA. ESWT treatment significantly decreased the severity of cartilage lesions at both times as compared to rabbits with OA alone (P < 0.05). CONCLUSION ESWT reduced the progression of OA in rabbits. This effect may be related to decreased level of NO and is likely mediated by reduced chondrocyte apoptosis. ESWT may be a useful treatment for knee OA.
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Affiliation(s)
- Zhe Zhao
- Department of Orthopaedic Surgery, The General Hospital of Chinese People's Army Police Force, Yongding Road 69, Haidian District, Beijing, 100039, People's Republic of China
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McIlwraith CW, Frisbie DD, Kawcak CE. Evaluation of intramuscularly administered sodium pentosan polysulfate for treatment of experimentally induced osteoarthritis in horses. Am J Vet Res 2012; 73:628-33. [PMID: 22533393 DOI: 10.2460/ajvr.73.5.628] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess clinical, radiographic, histologic, and biochemical effects of sodium pentosan polysulfate (NaPPS) administered IM for treatment of experimentally induced osteoarthritis in horses. ANIMALS 18 horses. PROCEDURES Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Nine horses received NaPPS (3 mg/kg, IM) on study days 15, 22, 29, and 36. Nine control horses received the same volume of saline (0.9% NaCl) solution IM on study days 15, 22, 29, and 36. Clinical, radiographic, gross, histologic, histochemical, and biochemical findings as well as findings of synovial fluid analysis were evaluated. RESULTS No adverse treatment-related events were detected. Induced osteoarthritis caused a substantial increase in lameness, response to flexion, joint effusion, radiographic findings, synovial membrane inflammation, and articular cartilage fibrillation. Articular cartilage fibrillation was substantially reduced by NaPPS treatment, and concentrations of chondroitin sulfate 846 epitope were significantly increased in the synovial fluid of osteoarthritic and non-osteoarthritic joints of treated horses. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that NaPPS has some beneficial disease-modifying effects and may be a therapeutic option for osteoarthritis in horses.
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Affiliation(s)
- C Wayne McIlwraith
- Gail Holmes Equine Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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Cinar BM, Circi E, Guven G, Tuncay IC, Hersekli MA, Derincek A. Extracorporeal shock waves in articular cartilage defects in the rats. Musculoskelet Surg 2012; 96:23-28. [PMID: 21671100 DOI: 10.1007/s12306-011-0145-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 05/27/2011] [Indexed: 05/30/2023]
Abstract
Thirty adult Sprague-Dawley rats were used to assess the nature of healing tissues in hyaline cartilage defects and to compare the healing in defects treated with shock waves, with those in defects without treatment. A 2 × 2 mm cartilage defect with exposed cancellous bone was created in a nonweight-bearing area of each medial femoral condyle. Each right knee defect was received extracorporeal shock waves (Swiss Dolorclast) of 500 impulses in 5 min at 2 bar (comparative to 0.09 mJ/mm(2)), and the left knee defects were assigned as controls. The rat groups were sacrificed at 6 and 12 weeks postsurgery. Sections from each knee were stained with hematoxylin-eosin to analyze synovial adhesion, synovial thickness, bone maturation, and chondroid metaplasia and with masson trichrome to analyze collagen fiber intensity. There was not a significant difference found between the study and control groups (P > 0.05). Extracorporeal shock waves did not effect healing of the chondral defects.
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Affiliation(s)
- Bekir Murat Cinar
- Department of Orthopaedics and Traumatology, Baskent University Medical Faculty, Adana, Turkey.
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Kawcak CE, Frisbie DD, McIlwraith CW. Effects of extracorporeal shock wave therapy and polysulfated glycosaminoglycan treatment on subchondral bone, serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis. Am J Vet Res 2011; 72:772-9. [PMID: 21627523 DOI: 10.2460/ajvr.72.6.772] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of extracorporeal shock wave therapy (ESWT) and polysulfated glycosaminoglycan treatment (PSGAGT) on subchondral bone (SCB), serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis. ANIMALS 24 healthy 2- to 3-year-old horses. PROCEDURES An osteochondral fragment was created on the distal aspect of the radial carpal bone in 1 middle carpal joint of each horse. Horses were randomly allocated to receive local application of ESWT (days 14 and 28; n = 8), PSGAGT (IM, q 4 d for 28 days; 8), or a sham ESWT probe (placebo; days 14 and 28; 8). Serum biomarkers were measured every 7 days, and synovial fluid biomarkers were measured every 14 days. Bone density was measured by use of computed tomography on days 0 and 70, and microdamage and bone formation variables were compared among groups at the end of the study (day 70). RESULTS There was no significant effect of ESWT or PSGAGT on any bone variable. Serum osteocalcin concentration was significantly greater in horses that received ESWT, compared with placebo-treated horses, and serum concentration of the C-terminal telopeptide of type I collagen was significantly higher in horses that received ESWT, compared with placebo- and PSGAG-treated horses. Concentrations of the synovial fluid epitope CS846 were significantly higher in joints with osteoarthritis treated with ESWT CONCLUSIONS AND CLINICAL RELEVANCE: Treatment of osteoarthritis with ESWT had no effect on SCB but did induce increases in serum biomarkers indicative of bone remodeling. Treatment of osteoarthritis with PSGAG had no effect on SCB or biomarkers.
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Affiliation(s)
- Chris E Kawcak
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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Park SA, Kim JH, Ahn JT, Kim WT, Park CG, Jeong MB, Yi SS, Yoon YS, Yoon JH, Kim HG, Seo KM. Effect of Mixed Extract of Panax Notoginseng, Rehmanniae Radix and Acanthopanacis Cortex (AIF) on Experimentally Induced Osteoarthritis. Biomol Ther (Seoul) 2010. [DOI: 10.4062/biomolther.2010.18.4.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Extracorporeal shockwave shows regression of osteoarthritis of the knee in rats. J Surg Res 2010; 171:601-8. [PMID: 20851422 DOI: 10.1016/j.jss.2010.06.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 05/27/2010] [Accepted: 06/18/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study investigated the effects of extracorporeal shockwave technology (ESWT) in osteoarthritis of the knee in rats. MATERIALS AND METHODS Thirty-six Sprague-Dawley rats were randomly divided into three groups with 12 rats in each group. Group I was the control group and received neither anterior cruciate ligament transection (ACLT) nor ESWT. In groups II and III, ACLT was performed in left knee and osteoarthritis (OA) was verified at 12 wk. Group II received no ESWT, and group III received ESWT at 12 wk after ACLT. Radiographs and bone mineral density (BMD) were obtained at 0, 12, and 24 wk. The animals were sacrificed at 24 wk. One half of the animals were subjected to bone strength test, and the other half for histomorphologic examination and immunohistochemical analysis. RESULTS Radiographs of the left knee showed progressive OA changes at 12 and 24 wk in group II, whereas, very subtle OA changes were noted in group I and group III. BMD and bone strength were significantly lower in group II compared with groups I and III, but no difference was noted between group I and group III. The cartilage degradations were significantly higher in group II compared with groups I and III, but no difference was noted between group I and group III. The subchondral bone remodeling was significantly less pronounced in group II compared with groups I and III, but no difference was noted between group I and group III. CONCLUSIONS Application of ESWT to the subchondral bone of the medial tibia condyle showed regression of osteoarthritis of the knees in rats.
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Shockwave therapy: Is there an application to enhance wound healing in horses? EQUINE VET EDUC 2010. [DOI: 10.2746/095777309x478590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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