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Published in: Arthritis Research & Therapy 4/2014

Open Access 01-08-2014 | Research article

Extracorporeal shockwave therapy in osteoporotic osteoarthritis of the knee in rats: an experiment in animals

Authors: Ching-Jen Wang, Chien-Yiu Huang, Shan-Ling Hsu, Jen-Hung Chen, Jai-Hong Cheng

Published in: Arthritis Research & Therapy | Issue 4/2014

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Abstract

Introduction

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

Methods

Fifty-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.

Results

On 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.

Conclusions

Osteoporosis 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.
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Literature
1.
go back to reference Lane NE, Nevitt MC: Osteoarthritis, bone mass, and fractures: how are they related?. Arthritis Rheum. 2002, 46: 1-4.CrossRefPubMed Lane NE, Nevitt MC: Osteoarthritis, bone mass, and fractures: how are they related?. Arthritis Rheum. 2002, 46: 1-4.CrossRefPubMed
2.
go back to reference Garrett NA, Brasure M, Schmitz KH, Schultz MM, Huber MR: Physical inactivity: direct cost to a health plan. Am J Prev Med. 2004, 27: 304-309.PubMed Garrett NA, Brasure M, Schmitz KH, Schultz MM, Huber MR: Physical inactivity: direct cost to a health plan. Am J Prev Med. 2004, 27: 304-309.PubMed
3.
go back to reference Ku PW, Fox KR, McKenna J, Peng TL: Prevalence of leisure-time physical activity in Taiwanese adults: results of four national surveys, 2000–2004. Prev Med. 2006, 43: 454-457.CrossRefPubMed Ku PW, Fox KR, McKenna J, Peng TL: Prevalence of leisure-time physical activity in Taiwanese adults: results of four national surveys, 2000–2004. Prev Med. 2006, 43: 454-457.CrossRefPubMed
4.
go back to reference Laborde JM, Powers MJ: Life satisfaction, health control orientation, and illness-related factors in persons with osteoarthritis. Res Nurs Health. 1985, 8: 183-190.CrossRefPubMed Laborde JM, Powers MJ: Life satisfaction, health control orientation, and illness-related factors in persons with osteoarthritis. Res Nurs Health. 1985, 8: 183-190.CrossRefPubMed
5.
go back to reference Osborne RH, Buchbinder R, Ackerman IN: Can a disease-specific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis?. BMC Musculoskel Disord. 2006, 7: 90-CrossRef Osborne RH, Buchbinder R, Ackerman IN: Can a disease-specific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis?. BMC Musculoskel Disord. 2006, 7: 90-CrossRef
6.
go back to reference Oettmeier R, Abendroth K: Osteoarthritis and bone: osteologic types of osteoarthritis of the hip. Skeletal Radiol. 1989, 18: 165-174.CrossRefPubMed Oettmeier R, Abendroth K: Osteoarthritis and bone: osteologic types of osteoarthritis of the hip. Skeletal Radiol. 1989, 18: 165-174.CrossRefPubMed
7.
go back to reference Mankin HJ, Dorfman H, Lippiello L, Zarins A: Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips, II. Correlation of morphology with biochemical and metabolic data. J Bone Joint Surg Am. 1971, 53: 523-537.PubMed Mankin HJ, Dorfman H, Lippiello L, Zarins A: Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips, II. Correlation of morphology with biochemical and metabolic data. J Bone Joint Surg Am. 1971, 53: 523-537.PubMed
8.
go back to reference Hayami T, Funaki H, Yaoeda K, Mitui K, Yamagiwa H, Tokunaga K, Hatano H, Kondo J, Hiraki Y, Yamamoto T, Duong le T, Endo N: Expression of the cartilage derived anti-angiogenic factor chondromodulin-I decreases in the early stage of experimental osteoarthritis. J Rheumatol. 2003, 30: 2207-2217.PubMed Hayami T, Funaki H, Yaoeda K, Mitui K, Yamagiwa H, Tokunaga K, Hatano H, Kondo J, Hiraki Y, Yamamoto T, Duong le T, Endo N: Expression of the cartilage derived anti-angiogenic factor chondromodulin-I decreases in the early stage of experimental osteoarthritis. J Rheumatol. 2003, 30: 2207-2217.PubMed
9.
go back to reference Dedrick DK, Goulet R, Huston L, Goldstein SA, Bole GG: Early bone changes in experimental osteoarthritis using microscopic computed tomography. J Rheumatol Suppl. 1991, 27: 44-45.PubMed Dedrick DK, Goulet R, Huston L, Goldstein SA, Bole GG: Early bone changes in experimental osteoarthritis using microscopic computed tomography. J Rheumatol Suppl. 1991, 27: 44-45.PubMed
10.
go back to reference Goker B, Sumner DR, Hurwitz DE, Block JA: Bone mineral density varies as a function of the rate of joint space narrowing in the hip. J Rheumatol. 2000, 27: 735-738.PubMed Goker B, Sumner DR, Hurwitz DE, Block JA: Bone mineral density varies as a function of the rate of joint space narrowing in the hip. J Rheumatol. 2000, 27: 735-738.PubMed
11.
go back to reference MacDonald BT, Joiner DM, Oyserman SM, Sharma P, Goldstein SA, He X, Hauschka PV: Bone mass is inversely proportional to Dkk1 levels in mice. Bone. 2007, 41: 331-339.PubMedCentralCrossRefPubMed MacDonald BT, Joiner DM, Oyserman SM, Sharma P, Goldstein SA, He X, Hauschka PV: Bone mass is inversely proportional to Dkk1 levels in mice. Bone. 2007, 41: 331-339.PubMedCentralCrossRefPubMed
12.
go back to reference Ohnaka K, Taniguchi H, Kawate H, Nawata H, Takayanagi R: Glucocorticoid enhances the expression of dickkopf-1 in human osteoblasts: novel mechanism of glucocorticoid-induced osteoporosis. Biochem Biophys Res Commun. 2004, 318: 259-264.CrossRefPubMed Ohnaka K, Taniguchi H, Kawate H, Nawata H, Takayanagi R: Glucocorticoid enhances the expression of dickkopf-1 in human osteoblasts: novel mechanism of glucocorticoid-induced osteoporosis. Biochem Biophys Res Commun. 2004, 318: 259-264.CrossRefPubMed
13.
go back to reference Castaneda S, Largo R, Calvo E, Rodriguez-Salvanes F, Marcos ME, Diaz-Curiel M, Herrero-Beaumont G: Bone mineral measurements of subchondral and trabecular bone in healthy and osteoporotic rabbits. Skeletal Radiol. 2006, 35: 34-41.CrossRefPubMed Castaneda S, Largo R, Calvo E, Rodriguez-Salvanes F, Marcos ME, Diaz-Curiel M, Herrero-Beaumont G: Bone mineral measurements of subchondral and trabecular bone in healthy and osteoporotic rabbits. Skeletal Radiol. 2006, 35: 34-41.CrossRefPubMed
14.
go back to reference Hart DJ, Mootoosamy I, Doyle DV, Spector TD: The relationship between osteoarthritis and osteoporosis in the general population: the Chingford Study. Ann Rheum Dis. 1994, 53: 158-162.PubMedCentralCrossRefPubMed Hart DJ, Mootoosamy I, Doyle DV, Spector TD: The relationship between osteoarthritis and osteoporosis in the general population: the Chingford Study. Ann Rheum Dis. 1994, 53: 158-162.PubMedCentralCrossRefPubMed
15.
go back to reference Dequeker J, Aerssens J, Luyten FP: Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res. 2003, 15: 426-439.CrossRefPubMed Dequeker J, Aerssens J, Luyten FP: Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship. Aging Clin Exp Res. 2003, 15: 426-439.CrossRefPubMed
16.
go back to reference Sambrook P, Naganathan V: What is the relationship between osteoarthritis and osteoporosis?. Baillieres Clin Rheumatol. 1997, 11: 695-710.CrossRefPubMed Sambrook P, Naganathan V: What is the relationship between osteoarthritis and osteoporosis?. Baillieres Clin Rheumatol. 1997, 11: 695-710.CrossRefPubMed
17.
go back to reference Stewart A, Black A, Robins SP, Reid DM: Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol. 1999, 26: 622-626.PubMed Stewart A, Black A, Robins SP, Reid DM: Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol. 1999, 26: 622-626.PubMed
18.
go back to reference Zhang Y, Hannan MT, Chaisson CE, McAlindon TE, Evans SR, Aliabadi P, Levy D, Felson DT: Bone mineral density and risk of incident and progressive radiographic knee osteoarthritis in women: the Framingham Study. J Rheumatol. 2000, 27: 1032-1037.PubMed Zhang Y, Hannan MT, Chaisson CE, McAlindon TE, Evans SR, Aliabadi P, Levy D, Felson DT: Bone mineral density and risk of incident and progressive radiographic knee osteoarthritis in women: the Framingham Study. J Rheumatol. 2000, 27: 1032-1037.PubMed
19.
go back to reference Calvo E, Castaneda S, Largo R, Fernandez-Valle ME, Rodriguez-Salvanes F, Herrero-Beaumont G: Osteoporosis increases the severity of cartilage damage in an experimental model of osteoarthritis in rabbits. Osteoarthritis Cartilage. 2007, 15: 69-77.CrossRefPubMed Calvo E, Castaneda S, Largo R, Fernandez-Valle ME, Rodriguez-Salvanes F, Herrero-Beaumont G: Osteoporosis increases the severity of cartilage damage in an experimental model of osteoarthritis in rabbits. Osteoarthritis Cartilage. 2007, 15: 69-77.CrossRefPubMed
20.
go back to reference Wang CJ, Weng LH, Ko JY, Sun YC, Yang YJ, Wang FS: Extracorporeal shockwave therapy shows chondroprotective effects in osteoarthritic rat knee. Arch Orthop Trauma Surg. 2011, 131: 1153-1158.CrossRefPubMed Wang CJ, Weng LH, Ko JY, Sun YC, Yang YJ, Wang FS: Extracorporeal shockwave therapy shows chondroprotective effects in osteoarthritic rat knee. Arch Orthop Trauma Surg. 2011, 131: 1153-1158.CrossRefPubMed
21.
go back to reference Wang CJ, Weng LH, Ko JY, Wang JW, Chen JM, Sun YC, Yang YJ: Extracorporeal shockwave shows regression of osteoarthritis of the knee in rats. J Surg Res. 2011, 171: 601-608.CrossRefPubMed Wang CJ, Weng LH, Ko JY, Wang JW, Chen JM, Sun YC, Yang YJ: Extracorporeal shockwave shows regression of osteoarthritis of the knee in rats. J Surg Res. 2011, 171: 601-608.CrossRefPubMed
22.
go back to reference Zhao Z, Ji H, Jing R, Liu C, Wang M, Zhai L, Bai X, Xing G: Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis. Arch Orthop Trauma Surg. 2012, 132: 1547-1553.CrossRefPubMed Zhao Z, Ji H, Jing R, Liu C, Wang M, Zhai L, Bai X, Xing G: Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis. Arch Orthop Trauma Surg. 2012, 132: 1547-1553.CrossRefPubMed
23.
go back to reference Weng LH, Wang CJ, Ko JY, Sun YC, Su YS, Wang FS: Inflammation induction of Dickkopf-1 mediates chondrocyte apoptosis in osteoarthritic joint. Osteoarthritis Cartilage. 2009, 17: 933-943.CrossRefPubMed Weng LH, Wang CJ, Ko JY, Sun YC, Su YS, Wang FS: Inflammation induction of Dickkopf-1 mediates chondrocyte apoptosis in osteoarthritic joint. Osteoarthritis Cartilage. 2009, 17: 933-943.CrossRefPubMed
24.
go back to reference Weng LH, Wang CJ, Ko JY, Sun YC, Wang FS: Control of Dkk-1 ameliorates chondrocyte apoptosis, cartilage destruction, and subchondral bone deterioration in osteoarthritic knees. Arthritis Rheum. 2010, 62: 1393-1402.CrossRefPubMed Weng LH, Wang CJ, Ko JY, Sun YC, Wang FS: Control of Dkk-1 ameliorates chondrocyte apoptosis, cartilage destruction, and subchondral bone deterioration in osteoarthritic knees. Arthritis Rheum. 2010, 62: 1393-1402.CrossRefPubMed
25.
go back to reference Weng LH, Ko JY, Wang CJ, Sun YC, Wang FS: Dkk-1 promotes angiogenic responses and cartilage matrix proteinase secretion in synovial fibroblasts from osteoarthritic joints. Arthritis Rheum. 2012, 64: 3267-3277.CrossRefPubMed Weng LH, Ko JY, Wang CJ, Sun YC, Wang FS: Dkk-1 promotes angiogenic responses and cartilage matrix proteinase secretion in synovial fibroblasts from osteoarthritic joints. Arthritis Rheum. 2012, 64: 3267-3277.CrossRefPubMed
26.
go back to reference Wang CJ: An overview of shock wave therapy in musculoskeletal disorders. Chang Gung Med J. 2003, 26: 220-232.PubMed Wang CJ: An overview of shock wave therapy in musculoskeletal disorders. Chang Gung Med J. 2003, 26: 220-232.PubMed
27.
go back to reference Wang CJ, Sun YC, Wong T, Hsu SL, Chou WY, Chang HW: Extracorporeal shockwave therapy shows time-dependent chondroprotective effects in osteoarthritis of the knee in rats. J Surg Res. 2012, 178: 196-205.CrossRefPubMed Wang CJ, Sun YC, Wong T, Hsu SL, Chou WY, Chang HW: Extracorporeal shockwave therapy shows time-dependent chondroprotective effects in osteoarthritis of the knee in rats. J Surg Res. 2012, 178: 196-205.CrossRefPubMed
28.
go back to reference Pickarski M, Hayami T, Zhuo Y, Duong Le T: Molecular changes in articular cartilage and subchondral bone in the rat anterior cruciate ligament transection and meniscectomized models of osteoarthritis. BMC Musculoskel Disord. 2011, 12: 197-CrossRef Pickarski M, Hayami T, Zhuo Y, Duong Le T: Molecular changes in articular cartilage and subchondral bone in the rat anterior cruciate ligament transection and meniscectomized models of osteoarthritis. BMC Musculoskel Disord. 2011, 12: 197-CrossRef
29.
go back to reference Herrero-Beaumont G, Roman-Blas JA: Osteoarthritis: osteoporotic OA: a reasonable target for bone-acting agents. Nat Rev Rheumatol. 2013, 9: 448-450.CrossRefPubMed Herrero-Beaumont G, Roman-Blas JA: Osteoarthritis: osteoporotic OA: a reasonable target for bone-acting agents. Nat Rev Rheumatol. 2013, 9: 448-450.CrossRefPubMed
30.
go back to reference Wang FS, Wang CJ, Chen YJ, Huang YT, Huang HC, Chang PR, Sun YC, Yang KD: Nitric oxide donor increases osteoprotegerin production and osteoclastogenesis inhibitory activity in bone marrow stromal cells from ovariectomized rats. Endocrinology. 2004, 145: 2148-2156.CrossRefPubMed Wang FS, Wang CJ, Chen YJ, Huang YT, Huang HC, Chang PR, Sun YC, Yang KD: Nitric oxide donor increases osteoprotegerin production and osteoclastogenesis inhibitory activity in bone marrow stromal cells from ovariectomized rats. Endocrinology. 2004, 145: 2148-2156.CrossRefPubMed
31.
go back to reference Wang CJ, Hsu SL, Weng LH, Sun YC, Wang FS: Extracorporeal shockwave therapy shows a number of treatment related chondroprotective effects in osteoarthritis of the knee in rats. BMC Musculoskel Disord. 2013, 14: 44-CrossRef Wang CJ, Hsu SL, Weng LH, Sun YC, Wang FS: Extracorporeal shockwave therapy shows a number of treatment related chondroprotective effects in osteoarthritis of the knee in rats. BMC Musculoskel Disord. 2013, 14: 44-CrossRef
32.
go back to reference Wang CJ, Sun YC, Siu KK, Wu CT: Extracorporeal shockwave therapy shows site-specific effects in osteoarthritis of the knee in rats. J Surg Res. 2013, 183: 612-619.CrossRefPubMed Wang CJ, Sun YC, Siu KK, Wu CT: Extracorporeal shockwave therapy shows site-specific effects in osteoarthritis of the knee in rats. J Surg Res. 2013, 183: 612-619.CrossRefPubMed
33.
go back to reference Bellido M, Lugo L, Roman-Blas JA, Castaneda S, Caeiro JR, Dapia S, Calvo E, Largo R, Herrero-Beaumont G: Subchondral bone microstructural damage by increased remodelling aggravates experimental osteoarthritis preceded by osteoporosis. Arthritis Res Ther. 2010, 12: R152-PubMedCentralCrossRefPubMed Bellido M, Lugo L, Roman-Blas JA, Castaneda S, Caeiro JR, Dapia S, Calvo E, Largo R, Herrero-Beaumont G: Subchondral bone microstructural damage by increased remodelling aggravates experimental osteoarthritis preceded by osteoporosis. Arthritis Res Ther. 2010, 12: R152-PubMedCentralCrossRefPubMed
34.
go back to reference Pritzker KP, Gay S, Jimenez SA, Ostergaard K, Pelletier JP, Revell PA, Salter D, van den Berg WB: Osteoarthritis cartilage histopathology: grading and staging. Osteoarthritis Cartilage. 2006, 14: 13-29.CrossRefPubMed Pritzker KP, Gay S, Jimenez SA, Ostergaard K, Pelletier JP, Revell PA, Salter D, van den Berg WB: Osteoarthritis cartilage histopathology: grading and staging. Osteoarthritis Cartilage. 2006, 14: 13-29.CrossRefPubMed
35.
go back to reference Radin EL, Rose RM: Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res. 1986, 213: 34-40.PubMed Radin EL, Rose RM: Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res. 1986, 213: 34-40.PubMed
36.
go back to reference Burr DB: The importance of subchondral bone in osteoarthrosis. Curr Opin Rheumatol. 1998, 10: 256-262.CrossRefPubMed Burr DB: The importance of subchondral bone in osteoarthrosis. Curr Opin Rheumatol. 1998, 10: 256-262.CrossRefPubMed
37.
go back to reference Burr DB, Schaffler MB: The involvement of subchondral mineralized tissues in osteoarthrosis: quantitative microscopic evidence. Microsc Res Tech. 1997, 37: 343-357.CrossRefPubMed Burr DB, Schaffler MB: The involvement of subchondral mineralized tissues in osteoarthrosis: quantitative microscopic evidence. Microsc Res Tech. 1997, 37: 343-357.CrossRefPubMed
Metadata
Title
Extracorporeal shockwave therapy in osteoporotic osteoarthritis of the knee in rats: an experiment in animals
Authors
Ching-Jen Wang
Chien-Yiu Huang
Shan-Ling Hsu
Jen-Hung Chen
Jai-Hong Cheng
Publication date
01-08-2014
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 4/2014
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar4601

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