Comparison of intraartiküler hyaluronic asid and ESWT (Extracorporeal Shock Wave Therapy) application in experimental osteocondral deffect in rats

ABSTRACTBackground and Aim: Treatment of osteochondral defects is a difficult issue in practice because of a low ability to repair of articular cartilage and healing mechanisms are not well known. However, if they are not treated, it seen that the healing of the lesions is inadequate. In vitro studies, it?s shown that hyaluronic acid has anti-inflammatory effect, inhibits leucocyte function, makes anesthesia and decreases friction in the joint. Extracorporeal Shock Wave Therapy (ESWT) is used for the treatment of various musculoskeletal problems. Mechanism of ESWT enhance neovascularization by increasing the synthesis of various growth factors and increasing migration, proliferation and differentiation of mesenchymal stem cells. In this study, intended to reveal positive effect of ESWT on osteochondral defect by comparison HA injection and ESWT application in the experimental osteochondral defects in rats.Materials and Methods: Ten for each group and totally 30 Wistar albino rats were used in this study. 1.5 mm diameter and 2 mm deep cylindrical full-thickness osteochondral defect was created with drill on the femoral side of the patellofemoral joint of the right knee of rats under anesthesia. The first group (control) rats were not applied to any treatment. 50 µg HA intraarticular applied in knee of rats in 2nd group (HA group) 3 times a week apart. ESWT (0.16 mJ/mm2 1000 pulse energy density) was applied on knee of rats in 3th group (ESWT group) 3 times a week apart. The rats are sacrificed after 4 weeks of treatment and specimens obtained from rats are evaluated histopathologically.Results: Histopathological results of ESWT and HA treatment groups compared to the untreated control group, there is statistically significant differences. HA and the ESWT group compared with histopathologic results do not differ significantly between the two group efficiency.Conclusion: ESWT, which is noninvasive, cost-effective, reproducible, and has less side effects, may be used in the treatment of osteochondral defects as an alternative method for surgery.Key Words: ESWT, osteochondral defect, hyaluronic acid, shock wave, rats.