Extracorporeal shockwave therapy shows regeneration in hip necrosis

被引：85

作者：

Wang, C. -J. ^{[1
]}

Wang, F. -S. ^{[4
]}

Ko, J. -Y. ^{[1
]}

Huang, H. -Y. ^{[2
]}

Chen, C. -J. ^{[3
]}

Sun, Y. -C. ^{[4
]}

Yang, Y. -J. ^{[4
]}

机构：

[1] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Orthoped Surg, Chang Gung Univ Sch Med, Kaohsiung 833, Taiwan

[2] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Pathol, Chang Gung Univ Sch Med, Kaohsiung 833, Taiwan

[3] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Arthritis & Rheumatol, Chang Gung Univ Sch Med, Kaohsiung 833, Taiwan

[4] Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Med Res, Chang Gung Univ Sch Med, Kaohsiung 833, Taiwan

来源：

RHEUMATOLOGY | 2008年 / 47卷 / 04期

关键词：

extracorporeal shockwave; regeneration; osteonecrosis; femoral head;

D O I：

10.1093/rheumatology/ken020

中图分类号：

R5 [内科学];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

Objectives. The effect of shockwave in osteonecrosis of the femoral head (ONFH) is poorly understood. The purpose. of this study was to investigate the regeneration effects of shockwave in ONFH. Methods. This study consisted of 14 femoral heads from 14 patients undergoing total hip arthroplasty for ONFH. Seven patients with seven hips who received shockwave prior to surgery were designated as the study group, whereas, seven patients with seven hips who did not receive shockwave were assigned to the control group. Both groups showed similar demographic characteristics. The femoral heads were investigated with histopathological examination and immunohistochemical analysis with von Willebrand factor (vWF), VEGF, platelet endothelial cell adhesion molecule-1 (PECAM-1) also referred to as (CD 31) and vascular cell adhesion molecule (VCAM) for angiogenesis, and with proliferation cell nuclear antigen (PCNA), Dickkopf-1 (DKK1) and Winless 3a (Wnt 3) for bone remodelling and regeneration. Results. In histopathological examination, the study group showed significantly more viable bone and less necrotic bone, higher cell concentration and more cell activities including phagocytosis than the control group. In immunohistochemical analysis, the study group showed significant increases in vWF (P < 0.01), VEGF (P = 0.0012) and CD 31 (P = 0.0023), Wnt3 (P = 0.008) and PCNA (P = 0.0011), and decreases in VCAM (P = 0.0013) and DKK1 (P = 0.0007) than the control group. Conclusions. Shockwave treatment significantly promotes angiogenesis and bone remodelling than the control. It appears that application of shockwave results in regeneration effects in hips with ONFH.

引用

页码：542 / 546

页数：5

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