Shockwave (ESWT) for osteoarthritis?

NewsBot · Jun 10, 2011

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Press Release:
SANUWAVE Extracorporeal Shock Wave Technology Shown to Prevent and Repair Osteoarthritis Damage in Preclinical Model

ALPHARETTA, GA, June 9, 2011 – SANUWAVE Health, Inc. (OTC/BB: SNWV)
(www.sanuwave.com), an emerging medical technology company focused on the development and commercialization of non-invasive, biological response activating devices in regenerative medicine, today reported the results of published preclinical osteoarthritis research conducted in Taiwan utilizing extracorporeal shock wave technology (ESWT) to prevent and repair osteoarthritis
damage. The study, entitled “Extracorporeal Shockwave Therapy Shows chondroprotective Effects in Osteoarthritic Rat Knee,” by Wang, C.J. et al., is available in the online edition of Archives of Orthopedic Trauma Surgery as an ePublication ahead of print.

Summary of Key Study Findings
A single ESWT procedure prevented or significantly improved surgically induced
osteoarthritis damage to the knee in an animal model. A single ESWT procedure significantly decreased articular cartilage degradation and improved subchondral bone remodeling. When treated with ESWT, surgically compromised knees displayed comparable data to the control group of normal, healthy knees at 12 weeks post-treatment. Multiple analyses of articular cartilage, subchondral bone, and blood and urine protein markers suggest that early application of ESWT provides a chondroprotective effect to prevent osteoarthritis onset.

The authors concluded that ESWT acts as a mechanotransduction catalyst that initiates complex biological pathways that lead to tissue regeneration in the knee joint. Christopher M. Cashman, President and CEO of SANUWAVE, said, “Osteoarthritis is no longer considered primarily a cartilage disease. It is a painful, crippling disease of the cartilage, subchondral and periarticular bone. This progressive disease is primarily treated with pharmaceutical regimens and surgery, including NSAIDs, steroids, synovial injections and joint replacement. Long-term pharmaceutical use and surgery can be expensive and carries inherent
risks to the patient.”

Christopher M. Cashman continued, “Several preclinical studies have shown that ESWT has a direct and positive effect on pre-existing joint diseases, including osteoarthritis. This latest study is important because it addresses prevention of disease onset and proves that ESWT is a viable early intervention to protect joints from the effects of osteoarthritis.”

Study Design and Results
The study utilized three groups of Sprague-Dawley rats, each containing nine animals. The animals in the first group (control) did not have their anterior cruciate ligaments (ACL) surgically cut, whereas animals in the other two groups had surgical transection of their ACL (ACLT) in order to induce osteoarthritis. Of the two ACLT groups, one group received a single ESWT procedure immediately following ACLT, while the other group received no treatment of any kind after ACLT. All animals underwent evaluations including radiograph, bone mineral density, serum levels of cartilage oligometric protein and osteocalcin, and urinary concentration of C-telopeptide of type II collagen (CTXII), and histomorphological examination before experiments began and then again at 12 weeks post-treatment for comparison. Statistical significance was set at p<0.05.

The two ACLT groups should have displayed significant increases in cartilage degradation by 12 weeks. However, the ACLT knee joints treated with ESWT showed improved, statistically significant levels of cartilage fissuring (p=0.039), chondrocyte concentrations (p=0.007) and chondrocyte activity (p=0.006) when compared to ACLT animals that did not receive ESWT. Similarly, the subchondral bone of the two ACLT groups should have displayed osteoarthritic changes, but again the ACLT knee joints treated with ESWT showed improved, statistically
significant percentages of trabecular bone (p=0.047) and fibrous tissue (p=0.001), as well as improved numbers of osteocytes (p<0.001), when compared to ACLT animals that did not receive ESWT. Bone mineral density (p=0.036), blood serum (p=0.002) and urine collagen levels (p=0.005) were all improved in the ACLT knee joints treated with ESWT compared to ACLT animals that did not receive ESWT.

Importantly, across all study parameters of articular cartilage, subchondral bone, and blood and urine protein markers, the ACLT knee joints treated with ESWT showed comparable data to the non-ACLT control group of normal, healthy knees at 12 weeks post-treatment. This strongly suggests that early application of ESWT provides a chondroprotective effect to prevent osteoarthritis onset.

A previous preclinical osteoarthritis study was performed by the same research group headed by Ching-Jen Wang, M.D., an orthopedic surgeon at Kaohsiung Chang Gung Memorial Hospital in Taiwan and a prominent researcher in the field of shock wave treatment. That study, which utilized surgically compromised knee joints in an animal model that mimicked fully developed osteoarthritis, revealed that ESWT treatment can reverse existing osteoarthritis joint damage. The results showed that osteoarthritic symptoms were reversed within 12 weeks of ESWT treatment. Based on these positive results, the research team proposed that early application of ESWT should have a chondroprotective effect and prevent osteoarthritic changes to the joint. This hypothesis formed the basis for this follow-up study, and Dr. Wang served as lead investigator. Dr. Wang said, "Based on these positive study results, ESWT treatment may offer an effective,
low-cost treatment option in humans that carries little risk compared with other treatments. This study is clinically relevant because it validates our original theory that ESWT treatment has a chondroprotective effect that repairs and prevents osteoarthritic changes in the knee joint.”

Mr. Cashman concluded, “We plan to continue supporting osteoarthritis research. If proven viable in later-stage clinical research, ESWT treatment could improve quality of life and return mobility to an ever growing, active, aging population suffering from the effects of osteoarthritis. Osteoarthritis affects 33 million people in the U.S. alone, and the market for treatments is estimated to grow to $7 billion globally by 2015. We currently offer orthoPACE® for orthopedic treatment in Europe as part of our Pulsed Acoustic Cellular Expression (PACE®) platform of proprietary ESWT devices, and orthoPACE is ideally suited for further research of osteoarthritis treatment in humans.”

About PACE
PACE, defined as Pulsed Acoustic Cellular Expression, delivers high-energy acoustic pressure waves in the shock wave spectrum to produce compressive and tensile stresses on cells and tissue structures to promote angiogenic and positive inflammatory responses, and quickly initiate the healing cascade. This results in revascularization and microcirculatory improvement, including the production of angiogenic growth factors, enhanced new blood vessel formation (angiogenesis), and the subsequent regeneration of tissue such as skin, musculoskeletal and vascular structures. PACE treatment triggers the initiation of an accelerated inflammatory response that speeds wounds into proliferation phases of healing and subsequently returns a chronic condition to an acute condition to help re-initiate the body’s own healing response.
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NewsBot · Jun 10, 2011

Extracorporeal shockwave therapy shows chondroprotective effects in osteoarthritic rat knee
Ching-Jen Wang, Lin-Hsiu Weng, Jih-Yang Ko, Yi-Chih Sun, Ya-Ju Yang and Feng-Sheng Wang
Archives of Orthopaedic and Trauma Surgery DOI: 10.1007/s00402-011-1289-2

Purpose
This study investigated the effects of extracorporeal shockwave therapy (ESWT) on the subchondral bone and articular cartilage in the initiation of osteoarthritis of the knee in rats.

Methods
Anterior cruciate ligament transected (ACLT) osteoarthritis (OA) rat knee model was used in this study. Twenty-seven male Sprague-Dawley rats were divided into three groups. The control group underwent sham surgery without ACLT and received no ESWT. The ACLT group underwent ACLT, but received no ESWT. The ACLT plus ESWT group underwent ACLT and received ESWT immediately after surgery. The evaluation parameters included radiograph, bone mineral density, serum levels of cartilage oligometric protein and osteocalcin, and urinary concentration of C-telopeptide of type II collagen (CTX-II), and histomorphological examination.

Results
At 12 weeks, OA of the knee was radiographically verified in the ACLT group, but very subtle changes were noticed in the control and the ACLT plus ESWT groups. On articular cartilage, the ACLT group showed significant increases in cartilage degradation and chondrocyte apoptosis compared to the control and ACLT plus ESWT groups. The ACLT plus ESWT group demonstrated significant decrease in the cartilage degradation and an increase in chondrocyte activity comparable to the control. In subchondral bone, the ACLT group showed a significant decrease in bone remodeling as compared to the control and ACLT plus ESWT groups. The ACLT plus ESWT group showed significant improvement in bone remodeling comparable to the control.

Conclusion
Extracorporeal shockwave therapy shows chondroprotective effect associated with improvement in subchondral bone remodeling in the initiation of ACLT OA knee model in rats.
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Admin2 · Jun 10, 2011

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house · May 22, 2013

Following on from these studies on the effect of shockwave on OA, I'd be interested to hear if anyone's had clinical success in any cases.
One of the podiatrists where I work had a patient with chronic dorsal midfoot OA (confirmed with Xray) who was desperate to try anything. They came in asking about shockwave and we told her that we couldnt say whether it would help or not, but that it could be of benefit.
Using radial ESWT, after 4 or 5 local treatments, the patient's symptoms were significantly better. We were somewhat surprised at the effect, but I guess based on the theory and some early research (eg improving healing in fractures and these studies above) it wasnt so far fetched after all!
Rory

Shockwave (ESWT) for osteoarthritis?

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Shockwave (ESWT) for osteoarthritis?

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

house Member

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Chattanooga RPW Mobile shockwave machine AS NEW

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Share This Page

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