VEGF-A expression in soft tissues repaired by shockwave therapy: differences between modalities

Shockwave therapy has found its place in the medical treatment of various diseases of the locomotor system such as acute fracture, nonunion, chronic tendinitis and pseudarthrosis. Focused shock waves enable maximum energy in the therapeutic zone, and depth of penetration can be adjusted. Radial shockwave therapy primarily affects superficial tissues, so its application in medicine is doubtful. Our study aimed to assess long bone fracture healing in regard to soft tissues. For this investigation, 84 female Wistar rats were divided into a focused shockwave group (n=36), a radial shockwave group (n=36) and a control group (n=12). Conclusively, long bone fracture repair was enhanced in the shockwave groups. Comparison between focused shock waves and radial shock waves suggested that this latter strongly stimulated the processes of the healing, as 75% of vascular spaces were VEGF-A positive on the 5th day of bone healing, and 85% on the 22nd day of healing.