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

Abstract 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...

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Autores principales:	Wenkai Wu, Nicola Maffulli, John P. Furia, Lukas Meindlhumer, Katharina Sternecker, Stefan Milz, Christoph Schmitz
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	rESWT Biomineralization Mussel shell Calcein green Fracture non-union Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/b9e755fca84e46b09372d62bf5db19a1
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spelling	oai:doaj.org-article:b9e755fca84e46b09372d62bf5db19a12021-12-05T12:19:24ZExposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions10.1186/s13018-021-02852-11749-799Xhttps://doaj.org/article/b9e755fca84e46b09372d62bf5db19a12021-12-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02852-1https://doaj.org/toc/1749-799XAbstract 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.Wenkai WuNicola MaffulliJohn P. FuriaLukas MeindlhumerKatharina SterneckerStefan MilzChristoph SchmitzBMCarticlerESWTBiomineralizationMussel shellCalcein greenFracture non-unionOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rESWT Biomineralization Mussel shell Calcein green Fracture non-union Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	rESWT Biomineralization Mussel shell Calcein green Fracture non-union Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Wenkai Wu Nicola Maffulli John P. Furia Lukas Meindlhumer Katharina Sternecker Stefan Milz Christoph Schmitz Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
description	Abstract 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.
format	article
author	Wenkai Wu Nicola Maffulli John P. Furia Lukas Meindlhumer Katharina Sternecker Stefan Milz Christoph Schmitz
author_facet	Wenkai Wu Nicola Maffulli John P. Furia Lukas Meindlhumer Katharina Sternecker Stefan Milz Christoph Schmitz
author_sort	Wenkai Wu
title	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_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_sort	exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b9e755fca84e46b09372d62bf5db19a1
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Exposure of zebra mussels to radial extracorporeal shock waves: implications for treatment of fracture nonunions

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