Unfocused extracorporeal shock waves induce anabolic effects in osteoporotic rats

Authors

  • Olav P. van der Jagt,

    Corresponding author
    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
    • Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. T: +31-10-7043367; F: +31-10-7044690
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  • Jan H. Waarsing,

    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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  • Nicole Kops,

    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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  • Wolfgang Schaden,

    1. AUVA, Trauma Center Meidling, Vienna, Austria
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  • Holger Jahr,

    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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  • Jan A.N. Verhaar,

    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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  • Harrie Weinans

    1. Orthopaedic Research Laboratory, Erasmus MC, University Medical Center, Room EE-1614, Dr. Molewaterplein 50, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Abstract

Unfocused extracorporeal shock waves (UESW) have been shown to have an anabolic effect on bone mass. Therefore we investigated the effects of UESW on bone in osteoporotic rats with and without anti-resorptive treatment. Twenty-week-old rats were ovariectomized (n = 27). One group was treated with saline and another group with Alendronate (ALN) 2.4 µg/kg, 3×/week. UESW were applied 2 weeks after ovariectomy. Thousand UESW were applied to one hind leg, the contra-lateral hind leg was not treated and served as control. With the use of in vivo micro-CT scanning it was shown that in saline treated rats trabecular bone volume fraction (BV/TV) was higher at 2 weeks follow-up in UESW treated legs compared to control legs. However, at 4 and 10 weeks no difference was found. In ALN treated animals UESW led to a pronounced anabolic response resulting in an increase in BV/TV at all time-points. Furthermore, UESW resulted in increased cortical volume (CtV), higher trabecular connectivity and, more plate-like and thicker trabeculae. Biomechanical testing showed that UESW lead to a higher maximum force before failure and higher stiffness in all treatment groups. With histology abundant areas of intramembranous bone formation along the periosteal cortex and within the bone marrow were observed. In conclusion this study shows promising results for the use of UESW in the treatment of osteoporosis, especially when this treatment is combined with an anti-resorptive treatment. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 768–775, 2013

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