RESEARCH - Extracorporeal shock waves may promote healing at bone-tendon junction

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Extracorporeal shock waves may promote healing at bone-tendon junction

By Reuters Health

February 20, 2008

NEW YORK (Reuters Health), Feb 20 - Extracorporeal shock wave therapy

(ESWT) promotes osteogenesis and remodeling of tissue in

healing-delayed patellar bone-tendon joint (BTJ) injuries in a rabbit

model, according to a report by Hong Kong and Chinese researchers in

the February issue of the American Journal of Sports Medicine.

Although ESWT has been shown to be effective for delayed union and

nonunion in fracture repair and for chronic soft-tissue injuries, this

is the first study to examine its efficacy in treating delayed BTJ

healing.

Following an established model, the researchers, led by Dr. Lin Wang

of the Chinese University of Hong Kong, performed a partial

patellectomy on one hind leg of each of 28 mature female rabbits. The

distal one third of the patella and its fibrocartilage zone were

removed, and a 2 mm by 3 mm latex sheet fixed between the remaining

patella and the patellar tendon resulted in delayed healing.

The rabbits were randomly divided into a control group and an ESWT

group of 14 each; the latter received a single ESWT treatment six

weeks postoperatively. Half of the rabbits in each group were

euthanized at eight weeks following surgery, and the other half at 12

weeks. All underwent histologic analysis, and five of each subgroup of

seven had the operative quadriceps-patella-patellar tendon-tibia

(QPPT) complex harvested for mechanical testing before histologic

evaluation.

Radiographic measurements at eight and 12 weeks postoperatively showed

193% and 92% more new bone formation in the ESWT group versus the

control group, respectively (p < 0.01 in both cases).

In addition, when load-tested to failure, the harvested QPPT complexes

from rabbits in the ESWT group exhibited significantly greater

mechanical strength at both eight and 12 weeks postoperatively (p <

0.05 in both cases).

" In the present study, " the researchers wrote, " the enhanced

osteogenesis and accelerated restoration of the fibrocartilage zone in

the ESWT group with healing were reflected in the radiographic,

densitometric, and histologic evaluations at both cellular and matrix

levels. "

They suggest that their findings may be potentially clinically

applicable to using the middle third of the patellar tendon for

anterior cruciate ligament reconstruction.

By Baltic

Last Updated: 2008-02-19 16:30:14 -0400 (Reuters Health)

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