Shock wave therapy for femoral head necrosis—Pressure measurements inside the femoral head

• Published in: Journal of biomechanics Vol. 43; no. 11; pp. 2065 - 2069
• Main Authors: Hausdorf, J, Lutz, A, Mayer-Wagner, S, Birkenmaier, C, Jansson, V, Maier, M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 10.08.2010; Elsevier; Elsevier Limited
• Subjects: Animals; Biological and medical sciences; Bone; Diseases of the osteoarticular system; Diseases of the osteoarticular system. Orthopedic treatment; Dose-Response Relationship, Radiation; Femoral head necrosis; Femur Head - physiology; Femur Head - radiation effects; Femur Head Necrosis - physiopathology; Femur Head Necrosis - therapy; In Vitro Techniques; Lithotripsy - methods; Medical sciences; Physical Medicine and Rehabilitation; Pressure; Pressure measurement; Radiation Dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Shock wave; Swine; Vascular bone diseases; Pressure measurement; Bone; Femoral head necrosis; Shock wave; Femur; Femoral head; Diseases of the osteoarticular system; Instrumentation therapy; Osteonecrosis; Pig; Osteoarticular system; Biomechanics; Vertebrata; Mammalia; Treatment; Animal; Lithotripsy; Artiodactyla; Ungulata; Biomedical engineering
• ISSN: 0021-9290; 1873-2380
• DOI: 10.1016/j.jbiomech.2010.04.009

Abstract There is a persisting need for effective therapies of femoral head necrosis, a common bone disease. Promising clinical results have been stated for the treatment with extracorporeal shock waves (ESW). However, the effective remaining pressure in the target region inside the femoral head has never been determined. Aim of this study was to investigate whether ESW are able to propagate through bone without an excessive loss of pressure. The remaining ESW pressure generated by an electromagnetic device after passing a certain intraosseous distance within the femoral head was measured. Standardized holes were drilled in porcine femora and the absorption in relation to reference measurements in degassed water was determined. The results showed continuous attenuation of shock waves in bone. After a clinical relevant intraosseous distance of 10 mm an ESW pressure of ∼50% remained. In conclusion, ESW have the potential to reach necrotic regions with therapeutic pressure levels and to effectively treat femoral head necrosis.