Osteogenesis induced by extracorporeal shockwave in treatment of delayed osteotendinous junction healing

Ling Qin, Lin Wang, Margaret Wan Nar Wong, Chunyi Wen, Gang Wang, Ge Zhang, Kai Ming Chan, Wing Hoi Cheung, Kwok Sui Leung

Research output: Journal article publicationJournal articleAcademic researchpeer-review

31 Citations (Scopus)


Healing at the osteotendinous junction (OTJ) is challenging in orthopedic surgery. The present study aimed to test extracorporeal shockwave (ESW) in treatment of a delayed OTJ healing. Twenty-eight rabbits were used for establishing a delayed healing (DH) model at patella-patellar-tendon (PPT) complex after partial patellectomy for 4 weeks and then were divided intoDHandESWgroups. In the ESW group, a single ESW treatment was given at postoperative week 6 to the PPT healing complex. The samples were harvested at week 8 and 12 for radiographic and histological evaluations with seven samples for each group at each time point. Micro-CT results showed that new bone volume was 1.18 ± 0.61mm3 in the ESW group with no measurable new bone in the DH group at postoperative week 8. Scar tissue formed at the OTJ healing interface of theDH group, whereas ESW triggered high expression of VEGF in hypertrophic chondrocytes at week 8 and regeneration of the fibrocartilage zone at week 12 postoperatively. The accelerated osteogenesis could be explained by acceleration of endochondral ossification. In conclusion, ESW was able to induce osteogenesis at OTJ with delayed healing with enhanced endochondral ossification process and regeneration of fibrocartilage zone. These findings formed a scientific basis to potential clinical application of ESW for treatment of delayed OTJ healing. Published by Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)70-76
Number of pages7
JournalJournal of Orthopaedic Research
Issue number1
Publication statusPublished - 1 Jan 2010
Externally publishedYes


  • Delayed healing
  • Extracorporeal shockwave (ESW)
  • Osteogenesis
  • Osteotendinous junction
  • Partial patellectomy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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