Chondrocytes treated with different shock wave devices.

BACKGROUND: Shock wave treatment is used for several orthopedic diseases and there are different devices available. Until now, there have been no experimental studies on the effects of these different generators.

METHODS: We carried out an experimental study to compare the effects of three focused generators (electro-magnetic, piezoelectric and electro-hydraulic) as well as a radial generator on healthy and osteoarthritis chondrocytes.

RESULTS: By the analysis of our results, we may exclude significant differences between the different generators, even though there is a greater action specificity for electro-magnetic and piezoelectric generators.

CONCLUSIONS: The smaller size of the focus of the latter two generators guarantees a greater concentration of energy in the target. The biological effect of the increase of IL-10 and reduction of both N-Cadherin and B-Catenin in chondrocytes in healthy subjects and those affected by osteoarthritis confirms the therapeutic potential of ESWT in cartilage diseases, such as osteoarthritis. In clinical practice it is important to introduce the parameter of total energy. This allows us to standardize the treatment and to manage the variability related to the different types of device and size of the focus.

LEVEL OF EVIDENCE: IIb.