Comparing extracorporeal shock wave and hyaluronic acid in a rabbit cartilage defect model: the effects of ESW on cartilage defect

Abstract

Aim: To compare the efficiency of extracorporeal shock wave (ESW) treatment with hyaluronic acid (HA) viscosupplementation in an experimental rabbit cartilage defect model. Materials and methods: A total of 24 New Zealand rabbits were randomly divided into 4 groups: HA, ESW, ESW + HA, and control. Chondral defects were created in the left knees of the rabbits. HA viscosupplementation was performed on the HA and ESW + HA groups, and after 24 h, 0.16 mJ/mm2 ESW was performed on the ESW and ESW + HA groups. After an 8-week follow-up, the rabbits were sacrificed and histopathological examination of the defects was carried out. In addition, immunohistochemistry was performed by the avidin-biotin peroxidase method using vascular endothelial growth factor (VEGF), transforming growth factor beta 1 (TGF-beta 1), and type II collagen antibodies, and the results were evaluated semiquantitatively. Results: There was a significant difference between the control group and the ESW group in terms of Pineda score and type II collagen expression; between the control group and the HA group in terms of Pineda score, VEGF expression, type II collagen expression, and TGF-beta 1 expression; and between the control group and the ESW + HA group in terms of Pineda score, VEGF expression, type II collagen expression, and TGF-beta 1 expression. Conclusion: The results show that both treatment methods have positive therapeutic effects on the articular cartilage defect model in terms of the parameters studied.