Shockwave Targeting on Subchondral Bone Is More Suitable than Articular Cartilage for Knee Osteoarthritis

Chou WY, Cheng JH, Wang CJ, Hsu SL, Chen JH, Huang CY · International Journal of Medical Sciences

Aiming at the medial tibial subchondral bone beat aiming at the articular cartilage on histology, micro-CT, cartilage grading and synovial grading (P < 0.05 against both untreated osteoarthritis and the cartilage-aimed group). In the cartilage of the subchondral-bone group, TGF-beta1 expression rose and DMP-1, MMP-13 and ADAMTS-5 fell against both comparators. Shockwave at this dose damaged neither meniscal cartilage nor joint tissue against sham.

Population

Rats in five groups: sham, shockwave on an intact medial meniscus, untreated osteoarthritis after medial meniscectomy and ligament transection, and the same osteoarthritis treated on either the medial tibial subchondral bone or the medial articular cartilage

Intervention

800 shockwave impulses at 0.25 mJ/mm2, aimed either at subchondral bone or at the cartilage surface

Comparator

Untreated osteoarthritic knees, and the other aiming point

Limitations

A rat model, eight animals per group, one dose, one session, and from the same Kaohsiung laboratory as the other shockwave-targeting studies in this literature, with the same device and one author on the advisory committee of SANUWAVE Health, which makes it. Funded by the Chang Gung Medical Foundation and Taiwan's Ministry of Science and Technology (MOST 106-2314-B-182A-014). The finding that bone rather than cartilage is the target is a claim about where to aim in a rat knee a few millimetres across.