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 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 &lt; 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 &times; region and energy &times; side &times; 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

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 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.

scholarly journals Extra Corporeal Shock Wave – A New Wave of Therapy

2015 ◽  
Vol 03 (03) ◽  
pp. 129-134
Author(s):  
Eva Goyal ◽  
Guljot Singh ◽  
Vivek Sharma ◽  
Jaspreet Gill ◽  
Gagandeep Gupta
Keyword(s):  
Shock Wave ◽  
Treatment Outcome ◽  
Shock Waves ◽  
Medical Practice ◽  
Callus Formation ◽  
Extracorporeal Shock Wave Therapy ◽  
Bactericidal Effect ◽  
New Wave ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

AbstractExtracorporeal shock wave therapy (ESWT) has been enormously used in medical practice, especially for the management of various orthopedic and musculoskeletal disorders. Extracorporeal shock wave therapy has favorable effects on stimulating callus formation, inducing angiogenesis and bone regeneration and relieving pain. Studies also indicated that extra corporeal shock waves have a significant bactericidal effect on bone- and implant-associated infections. The present article reviews the various applications of extra corporeal shock wave therapy in the field of dentistry and the possibility of inculcating the useful properties of shock waves in improving the treatment outcome.

scholarly journals The Effect of the Extracorporeal Shock Wave Therapy on Scaphoid Fracture Nonunions

2018 ◽  
Vol 86 (March) ◽  
pp. 1-6
Author(s):  
AMR E. AHMED, M.Sc. OMAIMA KATTABEI, Ph.D. ◽  
AHMED F. GENEDY, M.D. ABER RAMADAN, Ph.D.
Keyword(s):  
Shock Wave ◽  
Scaphoid Fracture ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Fracture Nonunions

scholarly journals Extracorporeal Shock Wave Therapy for Achilles Tendinopathy

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Magdalena Stania ◽  
Grzegorz Juras ◽  
Daria Chmielewska ◽  
Anna Polak ◽  
Cezary Kucio ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Case Series ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Case Control Studies ◽  
Beneficial Effects ◽  
Extracorporeal Shock Wave ◽  
Case Series Study

Extracorporeal shock wave therapy (ESWT) is among the conservative treatments for Achilles tendinopathy. Unfortunately, no optimal application parameters have been determined that would ensure ESWT effectiveness in this condition. The aim of the paper is to use research reports on ESWT in patients with Achilles tendinopathy to help practising physiotherapists establish the most effective intervention parameters. A search was conducted using the following databases: PubMed, Scopus, EBSCOhost, and Web of Science. The papers were checked for relevant content and were included based on the following criteria: full-text article published in English and including comprehensive description of shock wave application. Twenty-two articles met the inclusion criteria. Most studies on the effectiveness of ESWT for Achilles tendinopathy included in this narrative review were randomized controlled trials. Two case-control studies, a case series study, prospective audit, clinical trial protocol, and a pilot study were also considered. The majority were prospective studies. Only a few authors presented the findings from retrospective observations. The two modalities of shock wave therapy used for Achilles tendinopathy are focused shock waves and radial shock waves. The literature contains reports presenting mainly beneficial effects of ESWT in patients with Achilles tendinopathy.

scholarly journals Analysis of the Histological Effect of the Shock Waves on the Integrated Musculature of the Quadriceps of Wistar Rats

2020 ◽  
Author(s):  
Rodrigo Santos Almeida ◽  
Raquel Ida Ferreira ◽  
Daniel Antero de Almeida Galdino ◽  
Ítalo Guilherme Giarola de Freitas Mariano ◽  
Newton Fonseca da Silveira ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Satellite Cells ◽  
Wistar Rats ◽  
Extracorporeal Shock Wave Therapy ◽  
High Energy ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
The Right ◽  
Histological Effect

Abstract Objective: Shock waves are high-energy, high-pressure mechanical sound pulses used in medicine since 1980 with lithotripsy in urolithiasis. In addition, studies have demonstrated the osteogenic effect of shock waves indicating their use in skeletal diseases. Although several articles describe the benefits of shock waves in muscle diseases, assessments of its histological effect on the process of cell regeneration are lacking. Therefore, the objetive of this study is evaluate the histological effect of extracorporeal shock wave therapy on the intact musculature of Wistar rats. Materials and Methods: Twelve Wistar rats, with a mean age of 8 weeks, were studied for a period of 21 days. The quadriceps muscle of the right paws was submitted to 3 sessions of extracorporeal shock wave therapy at weekly intervals. The left legs were used as a control. Subsequently, the animals were euthanized and the quadriceps muscles were biopsied for histological study using histological slides stained in hematoxylin-eosin and Gomori's trichomium. Muscle fiber size, morphology and number of nuclei, existence of inflammatory infiltration, satellite cell count, and number of vessels were evaluated. Statistical calculations were performed using software R version 3.5.2 using non-parametric methods. Continuous variables relating to the legs of the same animal were compared using the Wilcoxon paired test (signed-rank). Discrete variables were compared using Fisher's exact test with mid-p correction. Results were considered statistically significant when p <0.05. Result: In the musculature of the right paws, there was an increase in fibrovascular and satellite cells proliferation with a statistically significant difference (p <0.005). Conclusion: The demonstration of the angiogenic power and the proliferation of satellite cells induced by extracorporeal shock waves, it is possible to affirm that this constitutes promising therapy for several muscle injuries. The acceleration of muscle recovery in athletes stands out as a example, by minimizing the impact on the competitor's performance, reducing muscle pain and spasticity, and improving muscle strength in tendinopathies.

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