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Vol. 22, Art. 9 (pp. 119-131)    |    2021       

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Experimental evaluation of the effect of radial shock wave therapy on the formation of piezoelectric effects in bone tissue.

Vasilevich S.V., Kurchenko S.N.

Childrens rehabilitation center of orthopaedics and traumatology Ogonyok

Brief summary

Backgraund: The mechanisms of action of shock waves are associated with various biological reactions, including "mechanotransduction". Bone tissue under the influence of mechanical load is able to generate piezoelectric charges, which can be control signals for remodeling the bone structure. In the modern literature, we have not found works on the relationship of shock waves on the occurrence of piezoelectric discharges in the bone, which was the basis for the study. Aims: to qualitatively evaluate the effect of shockwave therapy (SWT) on the formation of piezoelectric potentials in bone tissue. Materials and methods: The material for the study was selected native femur and tibia of pigs. Macropreparations were released from soft tissues, and the same type of bone fragments were formed 8-10 cm long, consisting of a section of the diaphysis, metaepiphysis and epiphysis, as well as two bones united by an articular capsule (femur and tibia). The opposite ends of the test bone macropreparations were connected to the input of the analog-to-digital converter of the electrocardiograph. The electrical signal from the bone was recorded in the temporary ECG recording mode. Signal registration was performed on several areas of bone tissue at different distances from the point of application of the shock wave. The Storz Medical device (MASTERPULS 200) was used as a source of shock-wave impact. Pulse characteristics: radial, applicator with a diameter of 15 mm, 1 Hertz, up to 5 bar. The impact was applied to the bone in the zone of the diaphysis, metaphysis and epiphysis. We also evaluated changes in the amplitude of electric piezo charges when placing muscles and tendon tissue between the bone preparation and the SWT applicator. Results: The impact of a radial shock wave on the bone preparation caused piezoelectric impulses in it. The value of piezoelectric discharges depended on the acoustic (mineral) density of the bone and the energy of the impact on the bone. The maximum piezoelectric charge occurs in the bone diaphysis at the point closest to the emitter (up to 45 mV). Piezoelectric signals of different intensity were recorded in the whole bone preparation at a distance from the zone of application of the shock wave up to 5 cm. Charges were not registered in the adjacent bone (connected through a common joint capsule). The piezoelectric discharge quickly faded when the muscles or tendon tissue were placed between the shock wave emitter and the bone, as well as when the SWT emitter was not perpendicular to the bone surface. The piezoelectric signal was not registered when the shock wave was applied to the tendon area. Conclusions: Shock-wave action on the bone causes piezoelectric effects in it. Shock wave is a physiotherapy factor whose behavior in the human body can be simplified by the laws of acoustic wave propagation in environments. The "shock wave-bone-piezoelectric charge" model can be used for modeling and preliminary assessment of the impact of SWT.


Key words

shock wave therapy, piezoelectric effect, bone tissue, bone regeneration.

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