Se F. Effect of Radial Shock Wave Therapy on Reparative Regeneration of Bone Tissue (experimental study)

The thesis provides recent data on pathogenesis of radial Extracorporeal Shock Wave Therapy (rESWT) impact on reparative regeneration of bone tissue. The results of experimental studies on 95 adult rabbits were analysed. The animals were divided into 3 groups: the intact group (I), the control group (II) and experimental group (III). A standard model of hole-type penetration defect of the proximal tibial metadiaphisis was employed. After the trauma, the experimental group received 4 treatment sessions of rESWT to the injury site. The control group didn't receive rESWT treatment. The results of immunologic studies have revealed the reduction of immune cells activity (depletion phase) in animals after the experimental bone trauma on catabolic stage of general metabolic response to the injury (on day 2). The depletion phase is followed by the phase of gradual restoration of functional activity of immune cells (on days 15-45) on anabolic stage. However, by the end of the experiment immunological indicators in the control group of rabbits still remained low. Meanwhile, in rESWT experimental group after 4 treatment sessions the immune markers not only reached the initial values, but also significantly exceeded standard ones. The biochemical studies show that the levels of major metabolic markers of bone tissue (collagen and glycosaminoglycans) in serum and bone regenerate of experimental animals significantly reduced after the experimental bone trauma on catabolic stage of general metabolic response to the injury (on day 2). The following-up postoperative observation (on days 15-45) on anabolic stage revealed an increase of the synthesis of basic organic components of bone tissue. A significant rise in biochemical values was found in experimental animals after 4-session radial Extracorporeal Shock Wave Therapy when compared to the control group. Findings of our roentgen-morphological studies show no evidence of additional tissue damage after 4 treatment sessions rESWT in rabbits with the experimental defect of the tibial metadiaphisis. There were observed such bone microcirculation failures as vasodilation and increased permeability of the vessel walls. These events were accompanied by the release of blood cells from the capillaries and bone marrow sinusoids, which we term as "diffuse infiltration" of the bone marrow. The "diffuse infiltration" results in emergence of massive areas of the endosteal regenerate and its restructuring for the restoration of the tibia integrity.