The effect of shockwaves on mature and healing cortical bone

Abstract

SUMMARYIt has been proposed that high energy shockwaves could be used to creare microfractures in cortical bone. This quality might be exploited clinically to perforen closed osteotomies and promote healing in nonunion (15). However; no study has previously documented the effect of shockwaves on cortical bone "in vivo". We report an investigation designed to demonstrate the effect of shockwaves on mature cortical and healing bone. An osteotomy was performed on the tibiae of 37 lambs; two weeks later the operation site was exposed to shockwaves. Three weeks later the lambs were killed and specimens of the bone examined histologically and radiographically. Shockwaves had no effect on the periosteal surface of mature cortical bone, but on the endosteal surface some new trabecular bone was seen. Healing of bone was delayed by the shockwave therapy. We conclude that there is currently little place for shockwave treatment in clinical orthopaedics.

Effect of Extracorporeal Shock Waves on Bone: A Review of Shock Wave Experiments and the Mechanism of Shock Wave Action

“…The largest study of this kind was performed in lambs by Forriol et al (1994). Two different protocols were used to treat 37 lambs by osteotomy.…”

Influence of extracorporeal shock-wave application on normal bone in an animal model in vivo

“…6 This mismatch indicates the possibility of a strong direct action of the pressure pulse. 7 Unfortunately, investigations on mature bone after ESWA with energy flux densities (EFD) comparable to those applied in clinical and experimental use have resulted in inconsistent findings, ranging from almost no effect 8 to fracture. 9 In addition, there have been reports of side-effects on bone in connection with the use of ESWA on tendons.…”

Characterization of pseudarthrosis with ultrasound backscattered signals in rats

“…Several animal species have been used to create a pseudarthrosis 14,[17][18][19][20] , but the authors usually converge their attention to the relevance of vascularization or to the extension of the bone segment injured.…”