Introduction: Extracorporeal shockwave therapy (ESWT) is a new method of tr
eating insertion tendopathy and pseudo-arthrosis, the clinical importance o
f which cannot yet be definitively assessed, and the underlying mechanisms
of which are still unclear.
Aim: To develop an experimental set-up enabling the standardised applicatio
n of ESWT to human bone marrow cell culture and the determination of the ef
fect of ESWT.
Material and methods: After 14 days incubation, human bone marrow cell cult
ures were subjected to ESWT using 200/500 pulses at an energy flux densitie
s ED + of 0.03, 0.04, 0.07, 0.11 and 0.25 millijoule/mm(2). Samples were ob
tained for LDH measurement 15 minutes, 4 h and 18 h after ESWT. Transmissio
n light microscopy was carried out before and after ESWT to determine cell
numbers and for morphological analysis.
Results: Gaps in the cellular tissue first appear at an energy of 0.01 mill
ijoule/mm(2). At energies of 0.25 millijoule/mm(2), morphologically altered
cells thinned out cellular tissue with a cell-free focal zone are found. A
t low energy levels, defects ha;ie been repaired ca. 1 week after ESWT. No
significant increase in LDH was detected at any of the energy levels applie
d.
Conclusion: Increasing energy and higher pulse frequency is associated with
an increase in the size and number of holes in cellular tissue and in cell
separation. Regeneration capability (regrowth, sprouting, normal cell form
) decreases as the energy level increases. Changes can be detected even at
the lowest energy flux densities, which up until now had been assumed to ha
ve no effect on cell morphology or number. The standardised application of
ESWT to human bone marrow cell cultures provides reproducible results that
can be controlled by a placebo ESWT application.