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- Author or Editor: Gottlieb Ueltschi x
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Objective—To monitor the effect of focused extracorporeal shock wave therapy (ESWT) on bone and bone-tendon junction of horses without lameness by use of nuclear scintigraphy and thermography.
Animals—6 warmblood horses without lameness.
Procedure—The origin of the suspensory ligament at the metacarpus (OSL-MC) and the fourth metatarsal bone were treated at 2 time points (days 0 and 16) with 2,000 shocks applied by a focused ESWT device at an energy flux density of 0.15 mJ/mm2. One forelimb and 1 hind limb were treated, and the contralateral limbs served as controls. To document the effect of focused ESWT, nuclear scintigraphy was performed on days -1, 3, 16 (before second ESWT), and 19. Thermography was performed on days -1, 0 (1 hour after first ESWT), 1, 3, 8, 16 (twice; before and 1 hour after second ESWT), and 19. On days 3, 16 (first scans), and 19, thermography was performed before scintigraphy.
Results—Scintigraphically, significant variations in radiopharmaceutical activity at the OSL-MC were detected in treatment and control limbs. No significant differences, however, in mean temperature or radiopharmaceutical activity could be detected by use of thermography or nuclear scintigraphy, respectively, between the treatment and control limbs at any time point in response to ESWT.
Conclusions and Clinical Relevance—After 2 treatments of focused ESWT, no physiologic effect on the studied structures could be demonstrated by use of nuclear scintigraphy or thermography. Results of this study indicate that at currently used ESWT settings, no damage to the bone or bone-tendon junction should occur. (Am J Vet Res 2005;66:1836–1842)
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.