Changes of articular cartilage and subchondral bone after extracorporeal shockwave therapy in osteoarthritis of the knee

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.

Conditioned medium of mesenchymal stem cells delays osteoarthritis progression in a rat model by protecting subchondral bone, maintaining matrix homeostasis, and enhancing autophagy

“…Eighteen 12‐week‐old male Sprague Dawley rats‐(280–320 g) were used in the study. First, 12 rats were randomly picked out and received bilateral anterior cruciate ligament transection and destabilization of the medial meniscus according to the previous study (C. J. Wang, Cheng, Huang, et al, ), whereas the remaining six rats and 12 legs received sham arthrotomy. The 12 with surgeries were randomly divided into two groups, namely, PBS group (PBS) and CM group (CM), and the six with sham surgeries were normal control group (normal).…”

“…The animals were euthanized by CO 2 overdose at 8 weeks postoperatively, and the knee specimens were collected and analysed. The gross morphology of articular cartilage of femurs and tibias was inspected under a magnification scope (Carl Zeiss, Oberkochen, Germany) and scored following the protocol of a previous study (C. J. Wang, Cheng, Chou, et al, ) by a blinded observer. The specimens were fixed in 10% formalin for 72 hr and decalcified in EDTA solution.…”

“…Germany) and scored following the protocol of a previous study (C. J. Wang, Cheng, Chou, et al, 2017) by a blinded observer. The specimens were fixed in 10% formalin for 72 hr and decalcified in EDTA solution.…”

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

“…It is suggested that ESWT can generate radial or focused pressure waves which bring energy and propagate through tissue [62]. This physical force could stimulate biological effects in a treated area, and the biochemical mechanism of ESWT in OA might be associated with neovascularization, osteogenesis, and chondrogenesis [63][64][65]. In recent studies, ESWT might lead to upregulation of angiogenic growth factors including endothelial nitric oxide synthase (eNOS) and vessel endothelial growth factor (VEGF), which benefit to neovascularization [66].…”

Shock Wave Therapy for Osteoarthritis of the Knee

“…Традиционно применяют УВТ при остеоартритах и остеоартрозах коленного сустава [7,19,20,21], остеоартрозах суставов кисти, псевдоартроза, ложного сустава и т.д. [5,18,19]. Доказано влияние УВТ на эластический компонент связок и сухожилий, увеличение подвижности и уменьшение периода скованности в мелких суставах, снижение эксплицированности болевого синдрома [5].…”