Frisbie David D, Kawcak Christopher E, McIlwraith C Wayne
Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
Am J Vet Res. 2009 Apr;70(4):449-54. doi: 10.2460/ajvr.70.4.449.
OBJECTIVE-To assess the clinical, biochemical, and histologic effects of extracorporeal shock wave therapy (ESWT) in the treatment of horses with experimentally induced osteoarthritis (OA). ANIMALS-Twenty-four 2- to 3-year-old horses without evidence of lameness. PROCEDURES-OA was induced arthroscopically in 1 middle carpal joint of each horse. Fourteen days after induction of OA, horses were treated with a sham ESWT probe (placebo; n = 8), polysulfated glycosaminoglycan (PSGAG) administered IM every 4 days for 28 days as a positive control treatment (8), or ESWT administered on days 14 and 28 with a focused shock wave unit (8). Evaluations included clinical assessments of degree of lameness every 2 weeks and weekly synovial fluid analyses. Horses were euthanized 70 days after induction of OA, and gross pathologic and histologic examinations of cartilage and synovial membrane specimens were performed at necropsy. A generalized linear mixed model was used to compare outcomes among treatment groups. RESULTS-No adverse treatment-related events were detected in any horse. The degree of lameness in horses treated with ESWT improved significantly, compared with the degree of lameness in placebo- or PSGAG-treated horses. No disease-modifying effects were evident in results for synovial fluid, synovial membranes, or cartilage from the ESWT- or PSGAG-treated horses. CONCLUSIONS AND CLINICAL RELEVANCE-Although a disease-modifying effect of ESWT was not detected, the significant clinical effect of ESWT suggested that this modality should be considered for treatment of horses with OA in combination with another modality that does affect the disease process.
目的——评估体外冲击波疗法（ESWT）对实验性诱导骨关节炎（OA）马匹的临床、生化和组织学影响。
动物——24匹2至3岁无跛行迹象的马。
方法——通过关节镜在每匹马的1个腕中关节诱导OA。OA诱导14天后，用假ESWT探头（安慰剂；n = 8）治疗马匹，每4天肌肉注射多硫酸化糖胺聚糖（PSGAG）共28天作为阳性对照治疗（8匹），或在第14天和第28天用聚焦冲击波装置进行ESWT治疗（8匹）。评估包括每2周对跛行程度进行临床评估以及每周进行滑液分析。OA诱导70天后对马匹实施安乐死，尸检时对软骨和滑膜标本进行大体病理和组织学检查。使用广义线性混合模型比较各治疗组的结果。
结果——未在任何一匹马中检测到与治疗相关的不良事件。与安慰剂或PSGAG治疗的马匹相比，接受ESWT治疗的马匹跛行程度显著改善。在ESWT或PSGAG治疗的马匹的滑液、滑膜或软骨结果中未发现疾病改善作用。
结论及临床意义——尽管未检测到ESWT的疾病改善作用，但ESWT显著的临床效果表明，对于OA马匹的治疗，应考虑将这种方法与另一种确实影响疾病进程的方法联合使用。
