Effects of extracorporeal shock wave therapy on bone.
Authors: McClure Scott R, Van Sickle David, White M Randy
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Effects of Extracorporeal Shock Wave Therapy on Bone Extracorporeal shock wave therapy (ESWT) has demonstrated efficacy in stimulating bone formation in human medicine for over two decades, yet the precise biological mechanisms driving osteogenesis remain incompletely understood. McClure and colleagues investigated the effects of ESWT on equine bone through experimental models, delivering shock waves at varying energy levels and pulse frequencies to metacarpal and metatarsal bones whilst assessing both the osteogenic response and potential soft tissue complications in the distal limb. Their findings revealed that appropriately calibrated shock wave protocols stimulate new bone formation throughout the depth of the near cortex without causing iatrogenic damage to adjacent soft tissues—a critical safety consideration for clinical application. These results provide an evidence base for the clinical use of ESWT in horses with non-union fractures and other osseous pathologies, though practitioners should recognise that optimal energy and pulse parameters require careful selection to maximise therapeutic benefit. The study supports further investigation into standardised ESWT protocols for equine orthopaedic conditions, which could offer a non-invasive alternative or adjunct to conventional surgical management of bony lesions.
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Practical Takeaways
- •ESWT offers a non-invasive option for stimulating bone healing in equine limb injuries when properly dosed, with safety profile for surrounding soft tissues
- •Clinical application in horses is supported by preliminary evidence, though standardized protocols for energy levels and pulse numbers need further definition
- •Consider ESWT as adjunctive therapy for nonunion or delayed union cases in metacarpal/metatarsal bones where traditional management has plateaued
Key Findings
- •Extracorporeal shock wave therapy can stimulate osteogenesis when delivered at appropriate energy and pulse parameters
- •Shock wave therapy does not damage soft tissue in the distal equine limb
- •Shock waves stimulate bone formation throughout the depth of the near cortex of metacarpus and metatarsus
- •Shock wave therapy is routinely used in Europe for treating bone nonunions in humans despite incomplete understanding of mechanism