Abstract

IntroductionThis study investigated the effectiveness of extracorporeal shockwave therapy (ESWT) in osteoporotic (OP) osteoarthritis (OA) of rat knee.MethodsFifty-six rats were divided into seven groups including sham, OA, OP, OA + OP, OA + ESWT, OP + ESWT, and OA + OP + ESWT groups. The evaluations included gross pathology, bone mineral density (BMD), micro-computed tomography (micro-CT) scan, bone-strength test, histopathologic examination, and immunohistochemical analysis.ResultsOn gross pathology, group OA + OP showed larger areas of osteoarthritic changes than did groups OA and OP, as compared with the sham group. BMD and bone strength significantly decreased in groups OA, OP, and OA + OP relative to the sham group, and ESWT significantly improved BMD and bone-strength changes. On micro-CT scan, the subchondral plate thickness significantly decreased, and the bone porosity increased in groups OA, OP, and OA + OP, and ESWT significantly improved the changes in subchondral-plate thickness and bone porosity. In histopathologic examination, Mankin score and safranin O score significantly increased in groups OA and group OA + OP, but not in group OP relative to the sham group, and ESWT significantly improved the changes. In immunohistochemical analysis, Dickkopf-1 (DKK-1) significantly increased, but vessel endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), and bone morphogenetic protein 2 (BMP-2) decreased in groups OA, OP, and OA + OP relative to the sham group, and ESWT significantly reversed the changes.ConclusionsOsteoporosis increased the severity of cartilage damage in osteoarthritis of the knee. ESWT showed effectiveness in the reduction of osteoporotic osteoarthritis of the knee in rats.

Highlights

  • This study investigated the effectiveness of extracorporeal shockwave therapy (ESWT) in osteoporotic (OP) osteoarthritis (OA) of rat knee

  • Our study showed that increased DKK-1 expression correlated with the occurrence of knee OA

  • The purpose of this study was to investigate the effectiveness of ESWT in osteoporotic osteoarthritis of the knee in rats

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Summary

Introduction

This study investigated the effectiveness of extracorporeal shockwave therapy (ESWT) in osteoporotic (OP) osteoarthritis (OA) of rat knee. Recent studies demonstrated that application of ESWT to subchondral bone of the proximal tibia shows a chondroprotective effect in the initiation of OA of the knee and induces regression of established OA of the knee in rats [20,21,22]. ESWT was noted to have multifunctional effects in bone and cartilage. DKK-1 promotes ex vivo apoptosis of chondrocytes [23]. Our study showed that increased DKK-1 expression correlated with the occurrence of knee OA. Interruption of DKK-1 expression may ameliorate OA-induced chondrocyte apoptosis, cartilage loss, and subchondral bone damage [24], as well as decreased synovitis and hypervascularity in animals with OA knee [25]

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