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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 4, 592-599.
doi: 10.1302/0301-620X.84B4.11621  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Influence of extracorporeal shock-wave application on normal bone in an animal model in vivo

SCINTIGRAPHY, MRI AND HISTOPATHOLOGY

M. Maier, MD, Consultant Orthopaedic Surgeon1; S. Milz, MD, Senior Postdoc Researcher Anatomy2; T. Tischer, MD, Orthopaedic Registrar1; W. Münzing, MD, Physicist3; N. Manthey, MD, Consultant in Nuclear Medicine3; A. Stäbler, MD, Assistant Professor4; N. Holzknecht, MD, Consultant in Radiology4; C. Weiler, MD, Consultant in Pathology5; A. Nerlich, MD, Assistant Professor5; H. J. Refior, MD, Professor and Head1; and C. Schmitz, MD, Assistant Professor6

1 Department of Orthopaedic Surgery
2 Anatomic Institute
3 Department of Nuclear Medicine
4 Department of Clinical Radiology
5 Institute of Pathology, Ludwig-Maximilians University, Marchioninistrasse 15, D-81377 Munich, Germany.
6 Department of Anatomy and Cell Biology, RWTH University of Aachen, Pauwelsstrasse, Wendlingweg 2, 52057 Aachen, Germany.

Correspondence should be sent to Dr M. Maier.

There is little information about the effects of extracorporeal shock-wave about application the effects (ESWA) of on normal bone physiology. We have therefore investigated the effects of ESWA on intact distal rabbit femora in vivo. The animals received 1500 shock-wave pulses each of different energy flux densities (EFD) on either the left or right femur or remained untreated. The effects were studied by bone scintigraphy, MRI and histopathological examination.

Ten days after ESWA (0.5 mJ/mm2 and 0.9 mJ/mm2 EFD), local blood flow and bone metabolism were decreased, but were increased 28 days after ESWA (0.9 mJ/mm2). One day after ESWA with 0.9 mJ/mm2 EFD but not with 0.5 mJ/mm2, there were signs of soft-tissue oedema, epiperiosteal fluid and bone-marrow oedema on MRI. In addition, deposits of haemosiderin were found epiperiosteally and within the marrow cavity ten days after ESWA.

We conclude that ESWA with both 0.5 mJ/mm2 and 0.9 mJ/mm2 EFD affected the normal bone physiology in the distal rabbit femur. Considerable damaging side-effects were observed with 0.9 mJ/mm2 EFD on periosteal soft tissue and tissue within the bone-marrow cavity.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General