Poenaru 2022 | Biological effects
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Poenaru D, Sandulescu MI, Cinteza D. Biological effects of extracorporeal shockwave therapy in tendons: A systematic review. Biomed Rep. 2022 Dec 29;18(2):15.
Systematic review. • 23 articles were included on ESWT application in human or animal tendons, either in vivo or in vitro. Outcomes: • ESWT doses and the definition of the optimal dose, • Neoangiogenesis, • Histopathologic changes, • Biochemical changes, • Mechanical properties. Results: this systematic review outlines a large spectrum of biological effects. • An optimal dose is adapted for each species and each tendon; exceeding the optimal dose may lead to structural injury. • The biological effects may be grouped into neovascularization induction with extensive capillary formation from the peritendinous structures, cellularity (tenocytes activation and proliferation) and extracellular matrix changes, metalloprotease and cytokine modulation, as well as lubricin production. • As a result, the remodelled tendon displays improved biomechanical properties to resist stress.
Key message: Scientific papers agree on several structural alterations induced by ESWT that promote tendon healing. The therapy acts on both cellular and extracellular compartments of the tendon structure and results in improved biomechanical tendon properties.
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