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Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions

BACKGROUND: Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biom...

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Autores principales: Wu, Wenkai, Maffulli, Nicola, Furia, John P., Meindlhumer, Lukas, Sternecker, Katharina, Milz, Stefan, Schmitz, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642867/
https://www.ncbi.nlm.nih.gov/pubmed/34863222
http://dx.doi.org/10.1186/s13018-021-02852-1
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author Wu, Wenkai
Maffulli, Nicola
Furia, John P.
Meindlhumer, Lukas
Sternecker, Katharina
Milz, Stefan
Schmitz, Christoph
author_facet Wu, Wenkai
Maffulli, Nicola
Furia, John P.
Meindlhumer, Lukas
Sternecker, Katharina
Milz, Stefan
Schmitz, Christoph
author_sort Wu, Wenkai
collection PubMed
description BACKGROUND: Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. METHODS: Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 h. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. RESULTS: General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. CONCLUSIONS: As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy.
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spelling pubmed-86428672021-12-06 Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions Wu, Wenkai Maffulli, Nicola Furia, John P. Meindlhumer, Lukas Sternecker, Katharina Milz, Stefan Schmitz, Christoph J Orthop Surg Res Research Article BACKGROUND: Radial extracorporeal shock wave therapy (rESWT) is an attractive, non-invasive therapy option to manage fracture nonunions of superficial bones, with a reported success rate of approximately 75%. Using zebra mussels (Dreissena polymorpha), we recently demonstrated that induction of biomineralization after exposure to focused extracorporeal shock waves (fESWs) is not restricted to the region of direct energy transfer into calcified tissue. This study tested the hypothesis that radial extracorporeal shock waves (rESWs) also induce biomineralization in regions not directly exposed to the shock wave energy in zebra mussels. METHODS: Zebra mussels were exposed on the left valve to 1000 rESWs at different air pressure (between 0 and 4 bar), followed by incubation in calcein solution for 24 h. Biomineralization was evaluated by investigating the fluorescence signal intensity found on sections of the left and right valves prepared two weeks after exposure. RESULTS: General linear model analysis demonstrated statistically significant (p < 0.05) effects of the applied shock wave energy as well as of the side (left/exposed vs. right/unexposed) and the investigated region of the valve (at the position of exposure vs. positions at a distance to the exposure) on the mean fluorescence signal intensity values, as well as statistically significant combined energy × region and energy × side × region effects. The highest mean fluorescence signal intensity value was found next to the umbo, i.e., not at the position of direct exposure to rESWs. CONCLUSIONS: As in the application of fESWs, induction of biomineralization by exposure to rESWs may not be restricted to the region of direct energy transfer into calcified tissue. Furthermore, the results of this study may contribute to better understand why the application of higher energy flux densities beyond a certain threshold does not necessarily lead to higher success rates when treating fracture nonunions with extracorporeal shock wave therapy. BioMed Central 2021-12-04 /pmc/articles/PMC8642867/ /pubmed/34863222 http://dx.doi.org/10.1186/s13018-021-02852-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wu, Wenkai
Maffulli, Nicola
Furia, John P.
Meindlhumer, Lukas
Sternecker, Katharina
Milz, Stefan
Schmitz, Christoph
Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title_full Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title_fullStr Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title_full_unstemmed Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title_short Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
title_sort exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642867/
https://www.ncbi.nlm.nih.gov/pubmed/34863222
http://dx.doi.org/10.1186/s13018-021-02852-1
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