Maier M, Milz S, Tischer T, Münzing W, Manthey N, Stäbler A, Holzknecht N, Weiler C, Nerlich A, Refior H J, Schmitz C
Department of Orthopaedic Surgery, Ludwig-Maximilians University, Munich, Germany.
J Bone Joint Surg Br. 2002 May;84(4):592-9. doi: 10.1302/0301-620x.84b4.11621.
There is little information about the effects of extracorporeal shock-wave application (ESWA) on normal bone physiology. We have therefore investigated the effects of ESWA on intact distal rabbit femora in vivo. The animals received 1500 shock-wave pulses each of different energy flux densities (EFD) on either the left or right femur or remained untreated. The effects were studied by bone scintigraphy, MRI and histopathological examination. Ten days after ESWA (0.5 mJ/mm2 and 0.9 mJ/mm2 EFD), local blood flow and bone metabolism were decreased, but were increased 28 days after ESWA (0.9 mJ/mm2). One day after ESWA with 0.9 mJ/mm2 EFD but not with 0.5 mJ/mm2, there were signs of soft-tissue oedema, epiperiosteal fluid and bone-marrow oedema on MRI. In addition, deposits of haemosiderin were found epiperiosteally and within the marrow cavity ten days after ESWA. We conclude that ESWA with both 0.5 mJ/mm2 and 0.9 mJ/mm2 EFD affected the normal bone physiology in the distal rabbit femur. Considerable damaging side-effects were observed with 0.9 mJ/mm2 EFD on periosteal soft tissue and tissue within the bone-marrow cavity.
关于体外冲击波应用（ESWA）对正常骨生理的影响，目前所知甚少。因此，我们研究了ESWA对完整的兔股骨远端在体的影响。给动物的左或右股骨施加不同能量通量密度（EFD）的1500次冲击波脉冲，或者不进行处理。通过骨闪烁显像、磁共振成像（MRI）和组织病理学检查来研究其影响。ESWA（EFD为0.5 mJ/mm2和0.9 mJ/mm2）后10天，局部血流和骨代谢降低，但在ESWA（0.9 mJ/mm2）后28天升高。在EFD为0.9 mJ/mm2而非0.5 mJ/mm2的ESWA后1天，MRI显示有软组织水肿、骨膜外积液和骨髓水肿的迹象。此外，ESWA后10天在骨膜外和骨髓腔内发现含铁血黄素沉积。我们得出结论，EFD为0.5 mJ/mm2和0.9 mJ/mm2的ESWA均影响兔股骨远端的正常骨生理。观察到EFD为0.9 mJ/mm2时对骨膜软组织和骨髓腔内组织有相当大的损伤性副作用。
