Skip to main content
SpringerLink
Log in

The long-term effects of extracorporeal shock waves on the epiphysis of the adolescent rat

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Extracorporeal shock waves (ESW) have been successfully used to treat musculoskeletal injuries, tendinopathy, and plantar fasciitis. Different side effects of high-energy ESWT on bones, tendons, nerves, epiphysis, and cartilage have been discussed. Although the effects of ESW on the epiphysis in animal models have been described, no studies have investigated the long-term effect of ESW on the immature epiphysis in an animal model. The purpose of this study was to investigate the long-term effects of ESW on the immature epiphysis in rats.

Methods

Sixteen 4-week old Wistar albino rats, average weight 116.3 grams (109.6–120.2 g) were used for these experiments. The rats were randomly divided into two groups, the ESW 1500 pulses (ESW1500p) group (n = 8) and the ESW 3000 pulses (ESW3000p) group (n = 8). In the ESW1500p group, 1500 pulses, at 4 bar, of 1-Hz shockwaves were applied, once, to the left knees of the rats. In the ESW3000p group, 3000 pulses, at 4 bar, of 1-Hz shockwaves were applied, once, to the left knees of the rats. The right knees (n = 16) of the rats in the two groups were used as the controls. The animals were sacrificed after an 8-month follow-up period. Femoral epiphyses were assessed by use of histology. The femoral length (FL), tibial length (TL), and femoral supracondylar medio-lateral width (MLW) were measured.

Results

There was no statistically significant difference between FL, TL, and MLW for the three groups (P > 0.05). The average histological scores were 8.8 (7–10), 17.8 (15–22), and 2.7 (0–4) in the ESW1500p, the ESW3000p groups, and the controls, respectively. The average histological score for the ESW3000p group was significantly higher than those for the ESW1500p group and the controls (P < 0.001). The average histological score for the ESW1500p group was significantly higher than that for the controls (P < 0.001).

Conclusions

The histological findings of this study indicate that ESW increased the cellularity and basophilia of the extracellular matrix (ECM) in the adolescent rat epiphysis and there were no negative effects on extremity measurements in the long term.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chaussy C, Brendel W, Schmiedt E. Extracorporeally induced destruction of kidney stone by shock waves. Lancet. 1980;II:1265–8.

    Article  Google Scholar 

  2. Siebert W, Buch M. Extracorporeal shock waves in orthopaedics. Berlin: Springer; 1997.

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  4. Valchanov VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop. 1991;15:181–4.

    Google Scholar 

  5. Zwerver J, Dekker F, Pepping GJ. Patient guided Piezo-electric extracorporeal shockwave therapy as treatment for chronic severe patellar tendinopathy: a pilot study. BMC Musculoskelet Disord. 2010;8(11):28.

    Article  Google Scholar 

  6. Van Leeuwen MT, Zwerver J, van den Akker-Scheek I. Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature Review. Br J Sports Med. 2009;43(3):163–8.

    Article  PubMed  Google Scholar 

  7. Rompe JD, Hopf C, Kullmer K, Heine J, Burger R. Analgesic effect of ESWT on chronic tennis elbow. J Bone Joint Surg. 1996;B 78:233–7.

    Google Scholar 

  8. Staples MP, Forbes A, Ptasznik R, Gordon J, Buchbinder R. A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (tennis elbow). J Rheumatol. 2008;35(10):2038–46.

    PubMed  Google Scholar 

  9. Lin PC, Wang CJ, Yang KD, Wang FS, Ko JY, Huang CC, et al. Extracorporeal shockwave treatment of osteonecrosis of the femoral head in systemic lupus erythematosis. J Arthroplast. 2006;21:911–5.

    Article  Google Scholar 

  10. Mayer-Wagner S, Ernst J, Maier M, Chiquet M, Müller PE, Jansson V, Sievers B, Hausdorf J. The effect of high-energy extracorporeal shock waves on hyaline cartilage of adult rats in vivo. J Orthop Res. 2010;28:1050–6.

    PubMed  CAS  Google Scholar 

  11. Wang CJ, Wang FS, Yang KD, Huang CC, Lee MS, Chan YS, Wang JW, Ko JY, et al. Treatment of osteonecrosis of the hip: comparison of extracorporeal shockwave with shockwave and alendronate. Arch Orthop Trauma Surg. 2008;128:901–8.

    Article  PubMed  CAS  Google Scholar 

  12. Chen YJ, Wang CJ, Yang KD, Kuo YR, Huang HC, Huang YT, Sun YC, Wang FS, et al. Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF-I expression. J Orthop Res. 2004;22(4):854–61.

    Article  PubMed  CAS  Google Scholar 

  13. Wang CJ, Huang HY, Pai CH. Shock wave enhances neovascularization at the tendon-bone junction. J Foot Ankle Surg. 2002;41:16–22.

    Article  PubMed  CAS  Google Scholar 

  14. Qin L, Wang L, Wong MW, Wen C, Wang G, Zhang G, Chan KM, Cheung WH, Leung KS. Osteogenesis induced by extracorporeal shockwave in treatment of delayed osteotendinous junction healing. J Orthop Res. 2010;28(1):70–6.

    PubMed  Google Scholar 

  15. Delius M, Draenert K, Al Diek Y, Draenert Y, et al. Biological effects of shock waves: in vivo effect of high energy pulses on rabbit bone. Ultrasound Med Biol. 1995;21:1219–25.

    Article  PubMed  CAS  Google Scholar 

  16. Micheli LJ, Fehlandt AF Jr. Overuse injuries to tendons and apophyses in children and adolescents. Clin Sports Med. 1992;11(4):713–26.

    PubMed  CAS  Google Scholar 

  17. Yeaman LD, Jerome CP, McCullough DL. Effects of shock waves on the structure and growth of the immature rat epiphysis. J Urol. 1989;141:670–4.

    PubMed  CAS  Google Scholar 

  18. Saisu T, Takahashi K, Kamegaya M, Mitsuhashi S, Wada Y, Moriya H, et al. Effects of extracorporeal shock waves on immature rabbit femurs. J Pediatr Orthop B. 2004;13:176–83.

    PubMed  Google Scholar 

  19. Nassenstein K, Nassenstein I, Schleberger R. Effects of high-energy shockwaves on the structure of the immature epiphysis —a histomorphological study. Z Orthop. 2005;143:652–5.

    Article  PubMed  CAS  Google Scholar 

  20. Ozturk H, Bulut O, Oztemur Z, Kaloglu C, Ozdemir-Kol I. Effect of high-energy extracorporeal shock waves in a rabbit model. Arc Orthop Trauma Surg. 2008;128:627–31.

    Article  Google Scholar 

  21. Clark PA. Comparison of decalcifying methods. Am J Clin Pathol. 1954;24:11–3.

    Google Scholar 

  22. Quintana-Villamandos MB, Sánchez-Hernández JJ, Delgado-Martos MJ, Delgado-Baeza E. Evolutional patterns of articular cartilage following growth plate injury in rats. J Orthop Sci. 2009;14(5):646–51.

    Article  PubMed  CAS  Google Scholar 

  23. Hutchinson MR, Ireland ML. Overuse and throwing injuries in skeletally immature athlete. Instr Course Lect. 2003;52:25–36.

    PubMed  Google Scholar 

  24. Cuff S, Loud K, O’Riordan MA. Overuse injuries in high school athletes. Clin Pediatr (Phila). 2010;49(8):731–6.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Feza Korkusuz for editing this study.

Conflict of interest

The authors declare they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Cumhuriyet University School of Medicine, Sivas, Turkey

    Zekeriya Oztemur, Hayati Ozturk & Okay Bulut

  2. Department of Orthopaedics and Traumatology, Izmir Military Hospital, Izmir, Turkey

    Selahattin Ozyurek

  3. Department of Histology and Embryology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

    Celal Kaloglu

  4. Clinic of Orthopaedics, Yuksekova Government Hospital, Yuksekova/Hakkari, Turkey

    Umut Hatay Golge

Authors
  1. Zekeriya Oztemur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hayati Ozturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Selahattin Ozyurek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Celal Kaloglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Umut Hatay Golge
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Okay Bulut
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zekeriya Oztemur.

About this article

Cite this article

Oztemur, Z., Ozturk, H., Ozyurek, S. et al. The long-term effects of extracorporeal shock waves on the epiphysis of the adolescent rat. J Orthop Sci 18, 159–164 (2013). https://doi.org/10.1007/s00776-012-0321-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-012-0321-x

Keywords

Search

Navigation