scholarly journals Exposure of zebra mussels to extracorporeal shock waves demonstrates formation of new mineralized tissue inside and outside the focus zone

2018 ◽  
Author(s):  
Katharina Sternecker ◽  
Juergen Geist ◽  
Sebastian Beggel ◽  
Kristin Dietz-Laursonn ◽  
Matias de la Fuente ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Signal Intensity ◽  
Zebra Mussels ◽  
Fluorescence Signal ◽  
Mineralized Tissue ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave ◽  
Calcified Tissue ◽  
Fracture Nonunions

AbstractA substantial body of evidence supports the use of extracorporeal shock wave therapy (ESWT) for fracture nonunions in human medicine. However, the success rate (i.e., radiographic union at six months after ESWT) is only approximately 75%. Detailed knowledge regarding the underlying mechanisms that induce bio-calcification after ESWT is limited. The aim of the present study was to analyze the biological response within mineralized tissue of a new invertebrate model organism, the zebra mussel Dreissena polymorpha, after exposure with extracorporeal shock waves (ESWs). Mussels were exposed to ESWs with positive energy density of 0.4 mJ/mm2 or were sham exposed. Detection of newly calcified tissue was performed by concomitantly exposing the mussels to fluorescent markers. Two weeks later, the fluorescence signal intensity of the valves was measured. Mussels exposed to ESWs showed a statistically significantly higher mean fluorescence signal intensity within the shell zone than mussels that were sham exposed. Additional acoustic measurements revealed that the increased mean fluorescence signal intensity within the shell of those mussels that were exposed to ESWs was independent of the size and position of the focal point of the ESWs. These data demonstrate that induction of bio-calcification after ESWT may not be restricted to the region of direct energy transfer of ESWs into calcified tissue. The results of the present study are of relevance for better understanding of the molecular and cellular mechanisms that induce formation of new mineralized tissue after ESWT. Specifically, bio-calcification following ESWT may extend beyond the direct area of treatment.Summary statementThe use of zebra mussels in research on extracorporeal shock wave (ESW) therapy for fracture nonunions allows new insights into the complex process of induction of biomineralization by ESWs.

scholarly journals Exposure of Zebra Mussels to Radial Extracorporeal Shock Waves: Implications for Treatment of Fracture Nonunions

2021 ◽  
Author(s):  
Wenkai Wu ◽  
Nicola Maffulli ◽  
John Furia ◽  
Lukas Meindlhumer ◽  
Katharina Sternecker ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Signal Intensity ◽  
Extracorporeal Shock Wave Therapy ◽  
Zebra Mussels ◽  
Fluorescence Signal ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave ◽  
Direct Energy ◽  
Fracture Nonunions

Background Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. Methods Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 hours. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. Results General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. Conclusions As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy.

scholarly journals Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenkai Wu ◽  
Nicola Maffulli ◽  
John P. Furia ◽  
Lukas Meindlhumer ◽  
Katharina Sternecker ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Signal Intensity ◽  
Extracorporeal Shock Wave Therapy ◽  
Zebra Mussels ◽  
Fluorescence Signal ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave ◽  
Direct Energy ◽  
Fracture Nonunions

Abstract Background Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. Methods Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 h. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. Results General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. Conclusions As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy.

scholarly journals Exposure of zebra mussels to extracorporeal shock waves demonstrates formation of new mineralized tissue inside and outside the focus zone

Biology Open ◽  
2018 ◽  
Vol 7 (7) ◽  
pp. bio033258 ◽  
Author(s):  
Katharina Sternecker ◽  
Juergen Geist ◽  
Sebastian Beggel ◽  
Kristin Dietz-Laursonn ◽  
Matias de la Fuente ◽  
...  
Keyword(s):  
Shock Waves ◽  
Zebra Mussels ◽  
Mineralized Tissue ◽  
Extracorporeal Shock Waves

scholarly journals The Efficacy of Unfocused Extracorporeal Shock Waves for the Treatment of Achilles Tendinopathy

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Ashraf M. Fansa ◽  
Martin J. O’Malley ◽  
Eoghan T. Hurley ◽  
John G. Kennedy
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave

Category: Sports Introduction/Purpose: Extracorporeal shock wave therapy (ESWT) may be a viable non-invasive treatment modality for patients suffering from Achilles Tendinopathy. There seems to be a relationship between the ESWT protocol and patient outcomes. Data suggest that higher energy levels of shock waves together with adequate treatment delivery to the affected area is necessary to achieve favorable outcomes. The aim of this study is present our experience with the use of electrohydraulically produced unfocused extracorporeal shock waves for the treatment of Achilles Tendinopathy. Methods: A retrospective analysis of prospectively collected data was performed, including all patients who had received ESWT for plantar fasciitis heel pain between January 2013 and September 2018. The primary outcomes included change in pain intensity on the visual analog pain scale and patient satisfaction at final follow-up. Pre and post-procedure Foot and Ankle Outcome Scores were also assessed for change. Results: A total of 158 patients (179 heels) were followed-up for a mean duration of 17 +- 6.8 months post ESWT. The mean pre-ESWT pain VAS improved from 7.2 +- 1.4 to 2.3 +- 2.1 (p< 0.001) at final follow-up. The FAOS Symptoms, Pain, Function of Daily Living, Function of Sports and Recreational activities and Quality of Life domains improved from 57.7 +- 12.7 to 79.7 +- 13.6 (p< 0.001), from 35 +- 15.8 to 72.6 +- 22 (p< 0.001), from 43.8 +- 15.3 to 81.4 +- 11 (p< 0.001), from 41.2 +- 21.3 to 66.4 +- 18.3 (p< 0.001) and from 33.9 +- 17.4 to 78 +- 24.4 (p< 0.001), respectively. Overall, 85.4% were satisfied with the procedure at final follow-up. Conclusion: For patients with Achilles tendinopathy, unfocussed extracorporeal shock wave therapy appears to be a safe and viable non-invasive treatment option with a patient satisfaction rate of 85.4% and a 68% reduction in patient reported pain intensity.

Effects of Shock Waves on Acceleration of Cell Growth Rate by Shock Tube

2008 ◽  
Author(s):  
Masaaki Tamagawa ◽  
Norikazu Ishimatsu
Keyword(s):  
Shock Wave ◽  
Growth Rate ◽  
Endothelial Cells ◽  
Shock Waves ◽  
Shock Tube ◽  
Test Case ◽  
Plane Shock ◽  
Extracorporeal Shock Wave ◽  
Shock Wave Pressure

This paper describes effects of shock waves on cells to certificate the angiogenesis by shock wave (pressure wave) in the clinical application such as ESW (Extracorporeal Shock Wave). Especially, to investigate the effects of shock waves on the endothelial cells in vitro, the cells worked by plane shock waves using shock tube apparatus are observed and measured in the microscope. The peak pressure working on the endothelial cells at the test case is 0.4 MPa. After working shock waves on suspended cells, growth rate (area per one cell and population of cells) are measured by image processing. It is found that the growth rate of the shock-worked cells from 0 to 4h is clearly high compared with control one. It is concluded that once shock waves worked, the cells have capacity to increase growth rate in vitro. This preliminary result will be applied to fundamental investigations about shock wave stimulus on several kinds of cells in future.

scholarly journals Extracorporeal shock waves act by shock wave-gas bubble interaction

1998 ◽  
Vol 24 (7) ◽  
pp. 1055-1059 ◽  
Author(s):  
Michael Delius ◽  
Friedrich Ueberle ◽  
Wolfgang Eisenmenger
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Gas Bubble ◽  
Extracorporeal Shock Waves ◽  
Bubble Interaction

scholarly journals Extracorporeal shock wave lithotripsy at 60 shock waves/min reduces renal injury in a porcine model

2009 ◽  
Vol 104 (7) ◽  
pp. 1004-1008 ◽  
Author(s):  
Bret A. Connors ◽  
Andrew P. Evan ◽  
Philip M. Blomgren ◽  
Rajash K. Handa ◽  
Lynn R. Willis ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Renal Injury ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Porcine Model ◽  
Extracorporeal Shock Wave

Induction of Microdamage Through Application of Acoustic Energy to Cortical Bone

2004 ◽  
Author(s):  
Andrea E. Tami ◽  
Melissa L. Knothe Tate ◽  
Jamie R. Streem ◽  
Ryan S. Comisford ◽  
Jared M. O’Leary ◽  
...  
Keyword(s):  
Shock Wave ◽  
Confocal Microscopy ◽  
Shock Waves ◽  
Bone Turnover ◽  
Cortical Bone ◽  
Kidney Stones ◽  
Acoustic Energy ◽  
Wave Number ◽  
Extracorporeal Shock Waves ◽  
Naturally Occurring

Extracorporeal shock waves (ESW) are used routinely to break up kidney stones. Recently ESW has been implemented in the orthopaedic arena to treat heel spurs, although the mechanism underlying this therapeutic effect is not known. Acoustic energy has been shown to increase transport in bone. Furthermore, naturally occurring microdamage in bone has been implicated as a trigger for the onset of remodeling. We hypothesize that controlled application of ESW to bone tissue increases transport and stimulates bone turnover through production of low-level microdamage. The goal of this study was to identify the bandwidth and the application regime of acoustic energy to produce such damage. Transverse sections of sheep metacarpi (1 cm) were subjected to acoustic loading regimes of varying shock wave number and intensity. Thereafter, the blocks were bulk-stained with procion dye, embedded in PMMA, and sectioned into 100 mm slices for confocal microscopy and analysis. The blocks loaded with the highest energy regimes showed marked diffuse microdamage and microcracks, usually at sites of discontinuity along the periosteal edge. These results provide a first step in testing our hypothesis and ultimately may provide a basis for the exploitation of ESW to prevent osteopenia and/or osteoporosis.

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