Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung, Taiwan.
J Surg Res. 2012 Nov;178(1):196-205. doi: 10.1016/j.jss.2012.01.010. Epub 2012 Apr 4.
Recent studies reported that extracorporeal shockwave therapy (ESWT) has a chondroprotective effect on the initiation and regression of osteoarthritis of the knee in rats. However, the time course effects of ESWT in the osteoarthritic knee are not fully understood. The purpose of this study was to evaluate the effects of ESWT over time on osteoarthritis of the knee in rats.
We used 72 8-week-old male Sprague-Dawley rats with body weights ranging from 245 to 265 g. We randomly divided the rats into three groups, with 24 rats in each group. The control group received neither surgery nor ESWT. The anterior cruciate ligament transected (ACLT) group underwent anterior cruciate ligament transection but received no ESWT. The ACLT plus ESWT group underwent ACL transection and received ESWT at 1 wk after surgery. The animals were killed at 2, 4, 8, and 12 wk, 6 rats from each group at each time course. Evaluation parameters included Mankin score, Safranin O stain, and collagen II for the articular cartilage; and vascular endothelial growth factor (VEGF), bone morphogenetic-2 (BMP-2), and osteocalcin for the subchondral bone using histopathological examination and immunohistochemical analysis.
The ACLT group showed significant increases in Mankin score and Safranin O stain, and a decrease in collagen II in the articular cartilage, and significant decreases in VEGF, BMP-2, and osteocalcin in the subchondral bone compared with the control (P < .05). The ACLT + ESWT group showed significant decreases in Mankin score and Safranin O stain and an increase in collagen II in the articular cartilage, and significant increases in VEGF, BMP-2, and osteocalcin in the subchondral bone compared with the control group. The changes in the ACLT + ESWT group appeared to correlate with the time courses of treatment; the most beneficial effects were noticed 4 weeks after ESWT.
Extracorporeal shockwave therapy is effective in preventing osteoarthritis of the knee in rats. The beneficial effects of ESWT appear to be time-dependent beginning at 4 weeks after treatment.
最近的研究报告称，体外冲击波疗法（ESWT）对大鼠膝关节骨关节炎的发生和消退具有软骨保护作用。然而，ESWT 在骨关节炎膝关节中的时间过程效应尚不完全清楚。本研究旨在评估 ESWT 随时间推移对大鼠膝关节骨关节炎的影响。
我们使用了 72 只 8 周龄雄性 Sprague-Dawley 大鼠，体重在 245 至 265 克之间。我们将大鼠随机分为三组，每组 24 只。对照组既未接受手术也未接受 ESWT。前交叉韧带切断（ACLT）组接受前交叉韧带切断，但未接受 ESWT。ACLT+ESWT 组接受 ACL 切断，并在手术后 1 周接受 ESWT。每组在每个时间点处死 6 只动物，共 6 只动物。评估参数包括关节软骨的 Mankin 评分、番红 O 染色和胶原 II；以及软骨下骨的血管内皮生长因子（VEGF）、骨形态发生蛋白-2（BMP-2）和骨钙素，采用组织病理学检查和免疫组织化学分析。
ACLT 组关节软骨的 Mankin 评分和番红 O 染色显著增加，胶原 II 减少，软骨下骨的 VEGF、BMP-2 和骨钙素显著减少，与对照组相比差异有统计学意义（P <.05）。ACLT+ESWT 组关节软骨的 Mankin 评分和番红 O 染色显著减少，胶原 II 增加，软骨下骨的 VEGF、BMP-2 和骨钙素显著增加，与对照组相比差异有统计学意义。ACLT+ESWT 组的变化似乎与治疗时间过程相关；在 ESWT 治疗后 4 周时观察到最有益的效果。
体外冲击波疗法对预防大鼠膝关节骨关节炎有效。ESWT 的有益效果似乎是时间依赖性的，从治疗后 4 周开始。
