Skip to main content
SpringerLink
Log in

Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Shirai T, Kobayashi M, Nishitani K, Satake T, Kuroki H, Nakagawa Y, Nakamura T (2011) Chondroprotective effect of alendronate in a rabbit model of osteoarthritis. J Orthop Res 29(10):1572–1577. doi:10.1002/jor.21394

    Article  PubMed  CAS  Google Scholar 

  2. Hawker GA, Mian S, Bednis K, Stanaitis I (2011) Osteoarthritis year 2010 in review: non-pharmacologic therapy. Osteoarthr Cartil 19(4):366–374. doi:10.1016/j.joca.2011.01.021

    Article  PubMed  CAS  Google Scholar 

  3. Kim HA, Blanco FJ (2007) Cell death and apoptosis in osteoarthritic cartilage. Curr Drug Targets 8(2):333–345

    Article  PubMed  CAS  Google Scholar 

  4. van der Kraan PM, van den Berg WB (2012) Chondrocyte hypertrophy and osteoarthritis: role in initiation and progression of cartilage degeneration? Osteoarthr Cartil 20(3):223–232. doi:10.1016/j.joca.2011.12.003

    Article  PubMed  Google Scholar 

  5. Endres S, Weiskirch M, Hinz C, Hutter F, Wilke A (2008) Extracorporeal shock-wave therapy in the treatment of pseudoarthrosis: a case report. Cases J 1(1):276. doi:10.1186/1757-1626-1-276

    Article  PubMed  Google Scholar 

  6. Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, Chales G (2007) High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg Br 89(3):335–341. doi:10.1302/0301-620X.89B3.18249

    Article  PubMed  Google Scholar 

  7. Staples MP, Forbes A, Ptasznik R, Gordon J, Buchbinder R (2008) A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (tennis elbow). J Rheumatol 35(10):2038–2046

    PubMed  Google Scholar 

  8. Metzner G, Dohnalek C, Aigner E (2010) High-energy Extracorporeal Shock-Wave Therapy (ESWT) for the treatment of chronic plantar fasciitis. Foot Ankle Int 31(9):790–796. doi:10.3113/FAI.2010.0790

    Article  PubMed  Google Scholar 

  9. Frisbie DD, Kawcak CE, McIlwraith CW (2009) Evaluation of the effect of extracorporeal shock wave treatment on experimentally induced osteoarthritis in middle carpal joints of horses. Am J Vet Res 70(4):449–454. doi:10.2460/ajvr.70.4.449

    Article  PubMed  Google Scholar 

  10. Revenaugh MS (2005) Extracorporeal shock wave therapy for treatment of osteoarthritis in the horse: clinical applications. Vet Clin North Am Equine Pract 21(3):609–625. doi:10.1016/j.cveq.2005.09.001

  11. Ochiai N, Ohtori S, Sasho T, Nakagawa K, Takahashi K, Takahashi N, Murata R, Moriya H, Wada Y, Saisu T (2007) Extracorporeal shock wave therapy improves motor dysfunction and pain originating from knee osteoarthritis in rats. Osteoarthr Cartil 15(9):1093–1096. doi:10.1016/j.joca.2007.03.011

    Article  PubMed  CAS  Google Scholar 

  12. Li X, Li J, Cheng K, Lin Q, Wang D, Zhang H, An H, Gao M, Chen A (2011) Effect of low-intensity pulsed ultrasound on MMP-13 and MAPKs signaling pathway in rabbit knee osteoarthritis. Cell Biochem Biophys 61(2):427–434. doi:10.1007/s12013-011-9206-4

    Article  PubMed  CAS  Google Scholar 

  13. Wang FS, Yang KD, Kuo YR, Wang CJ, Sheen-Chen SM, Huang HC, Chen YJ (2003) Temporal and spatial expression of bone morphogenetic proteins in extracorporeal shock wave-promoted healing of segmental defect. Bone 32(4):387–396 pii: S8756328203000292

    Article  PubMed  CAS  Google Scholar 

  14. Iwase Y, Kato J, Ohtaguro K (1989) Clinical experiences of Medstone 1050 ST on extracorporeal shock wave lithotripsy. Nihon Rinsho 47(12):2777–2780

    PubMed  CAS  Google Scholar 

  15. Yoshioka M, Coutts RD, Amiel D, Hacker SA (1996) Characterization of a model of osteoarthritis in the rabbit knee. Osteoarthr Cartil 4(2):87–98 pii: S1063-4584(05)80318-8

    Article  PubMed  CAS  Google Scholar 

  16. Vaterlein N, Lussenhop S, Hahn M, Delling G, Meiss AL (2000) The effect of extracorporeal shock waves on joint cartilage—an in vivo study in rabbits. Arch Orthop Trauma Surg 120(7–8):403–406

    Article  PubMed  CAS  Google Scholar 

  17. Renz H, Rupp S (2009) Effects of shock waves on chondrocytes and their relevance in clinical practice. Arch Orthop Trauma Surg 129(5):641–647. doi:10.1007/s00402-008-0668-9

    Article  PubMed  Google Scholar 

  18. Benson BM, Byron CR, Pondenis H, Stewart AA (2007) The effects of radial shock waves on the metabolism of equine cartilage explants in vitro. N Z Vet J 55(1):40–44. doi:10.1080/00480169.2007.36733

    Article  PubMed  CAS  Google Scholar 

  19. Mayer-Wagner S, Ernst J, Maier M, Chiquet M, Joos H, Muller PE, Jansson V, Sievers B, Hausdorf J (2010) The effect of high-energy extracorporeal shock waves on hyaline cartilage of adult rats in vivo. J Orthop Res 28(8):1050–1056. doi:10.1002/jor.21074

    PubMed  CAS  Google Scholar 

  20. Wang CJ, Weng LH, Ko JY, Wang JW, Chen JM, Sun YC, Yang YJ (2011) Extracorporeal shockwave shows regression of osteoarthritis of the knee in rats. J Surg Res 171(2):601–608. doi:10.1016/j.jss.2010.06.042

    Article  PubMed  Google Scholar 

  21. Ciampa AR, de Prati AC, Amelio E, Cavalieri E, Persichini T, Colasanti M, Musci G, Marlinghaus E, Suzuki H, Mariotto S (2005) Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. FEBS Lett 579(30):6839–6845. doi:10.1016/j.febslet.2005.11.023

    Article  PubMed  CAS  Google Scholar 

  22. Mariotto S, Cavalieri E, Amelio E, Ciampa AR, de Prati AC, Marlinghaus E, Russo S, Suzuki H (2005) Extracorporeal shock waves: from lithotripsy to anti-inflammatory action by NO production. Nitric Oxide 12(2):89–96. doi:10.1016/j.niox.2004.12.005

    Article  PubMed  CAS  Google Scholar 

  23. Moretti B, Iannone F, Notarnicola A, Lapadula G, Moretti L, Patella V, Garofalo R (2008) Extracorporeal shock waves down-regulate the expression of interleukin-10 and tumor necrosis factor-alpha in osteoarthritic chondrocytes. BMC Musculoskelet Disord 9:16. doi:10.1186/1471-2474-9-16

    Article  PubMed  Google Scholar 

  24. Abramson SB (2008) Nitric oxide in inflammation and pain associated with osteoarthritis. Arthr Res Ther 10(Suppl 2):S2. doi:10.1186/ar2463

    Article  Google Scholar 

  25. Hancock CM, Riegger-Krugh C (2008) Modulation of pain in osteoarthritis: the role of nitric oxide. Clin J Pain 24(4):353–365. doi:10.1097/AJP.0b013e31815e5418

    Article  PubMed  Google Scholar 

  26. Li D, Wu Z, Duan Y, Hao D, Zhang X, Luo H, Chen B, Qiu G (2011) TNFalpha-mediated apoptosis in human osteoarthritic chondrocytes sensitized by PI3K-NF-kappaB inhibitor, not mTOR inhibitor. Rheumatol Int. doi:10.1007/s00296-011-1929-4

    Google Scholar 

Download references

Acknowledgments

Project was supported by National Natural Science Foundation of China (No 31172169).

Author information

Authors and Affiliations

  1. 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

    Zhe Zhao, Huiru Ji, Chunmei Liu, Xiaodong Bai & Gengyan Xing

  2. Ultrasonic Diagnosis Department, The General Hospital of Chinese People’s Army Police Force, Yongding Road 69, Haidian District, Beijing, 100039, People’s Republic of China

    Rufang Jing

  3. Orthopaedic Department, Armed Police Inner Mongolia Unit Hospital, Huhehaote, 010040, People’s Republic of China

    Mingbo Wang

  4. Orthopaedic Department, Medical College Affiliated Hospital of Chinese People’s Armed Police Force, Tianjin, 300162, People’s Republic of China

    Lei Zhai

Authors
  1. Zhe Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Huiru Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rufang Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chunmei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mingbo Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lei Zhai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiaodong Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gengyan Xing
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gengyan Xing.

Additional information

Z. Zhao and H. Ji contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhao, Z., Ji, H., Jing, R. et al. Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis. Arch Orthop Trauma Surg 132, 1547–1553 (2012). https://doi.org/10.1007/s00402-012-1586-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-012-1586-4

Keywords

Search

Navigation