Histomorphologic evaluation of extracorporeal shock wave therapy of the fourth metatarsal bone and the origin of the suspensory ligament in horses without lameness

Andrea S. Bischofberger Equine Hospital, VETSUISSE Faculty, University of Zurich, 8057 Zürich, Switzerland.

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Simone K. Ringer Equine Hospital, VETSUISSE Faculty, University of Zurich, 8057 Zürich, Switzerland.

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Hans Geyer Division of Anatomy, VETSUISSE Faculty, University of Zurich, 8057 Zürich, Switzerland.

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Isabel Imboden Equine Hospital, VETSUISSE Faculty, University of Zurich, 8057 Zürich, Switzerland.

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Gottlieb Ueltschi Division of Radiology, Department of Clinical Veterinary Medicine, VETSUISSE Faculty, University of Berne, 3001 Berne, Switzerland.

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Christoph J. Lischer Equine Hospital, VETSUISSE Faculty, University of Zurich, 8057 Zürich, Switzerland.

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Abstract

Objective—To determine via histologic examination and scintigraphy the effect of focused extracorporeal shock wave therapy (ESWT) on normal bone and the bone-ligament interface in horses.

Animals—6 horses without lameness.

Procedure—Origins of the suspensory ligament at the metacarpus (35-mm probe depth) and fourth metatarsal bone (5-mm probe depth) were treated twice (days 0 and 16) with 2,000 shocks (energy flux density, 0.15 mJ/mm2). One forelimb and 1 hind limb were randomly treated, and the contralateral limbs served as nontreated controls. Bone scans were performed on days −1 (before ESWT), 3, 16, and 19. Histomorphologic studies of control and treated tissues were performed on day 30.

Results—ESWT significantly increased the number of osteoblasts but caused no damage to associated soft tissue structures and did not induce cortical microfractures. A significant correlation between osteoblast numbers and radiopharmaceutical uptake was noticed on lateral views of the hind limb on days 3 and 16 and on caudal views of the forelimb on day 3.

Conclusions and Clinical Relevance—Results suggested that ESWT has the potential to increase osteoblast numbers in horses. The correlation between increased osteoblast numbers and radio-pharmaceutical uptake 3 days and 16 days after the first ESWT suggested that stimulation of osteogenesis occurred soon after ESWT. No damage to bone or the bone-ligament interface should occur at the settings used in this study, and ESWT can therefore be administered safely in horses.

Abstract

Objective—To determine via histologic examination and scintigraphy the effect of focused extracorporeal shock wave therapy (ESWT) on normal bone and the bone-ligament interface in horses.

Animals—6 horses without lameness.

Procedure—Origins of the suspensory ligament at the metacarpus (35-mm probe depth) and fourth metatarsal bone (5-mm probe depth) were treated twice (days 0 and 16) with 2,000 shocks (energy flux density, 0.15 mJ/mm2). One forelimb and 1 hind limb were randomly treated, and the contralateral limbs served as nontreated controls. Bone scans were performed on days −1 (before ESWT), 3, 16, and 19. Histomorphologic studies of control and treated tissues were performed on day 30.

Results—ESWT significantly increased the number of osteoblasts but caused no damage to associated soft tissue structures and did not induce cortical microfractures. A significant correlation between osteoblast numbers and radiopharmaceutical uptake was noticed on lateral views of the hind limb on days 3 and 16 and on caudal views of the forelimb on day 3.

Conclusions and Clinical Relevance—Results suggested that ESWT has the potential to increase osteoblast numbers in horses. The correlation between increased osteoblast numbers and radio-pharmaceutical uptake 3 days and 16 days after the first ESWT suggested that stimulation of osteogenesis occurred soon after ESWT. No damage to bone or the bone-ligament interface should occur at the settings used in this study, and ESWT can therefore be administered safely in horses.

Contributor Notes

Supported by HMT High Medical Technologies AG.

Dr. Lischer.
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