Protective effects of extracorporeal shockwave on rat chondrocytes and temporomandibular joint osteoarthritis; preclinical evaluation with in vivo 99mTc-HDP SPECT and ex vivo micro-CT

Y. H. Kim, J. I. Bang, H. J. Son, Y. Kim, J. H. Kim, H. Bae, S. J. Han, H. J. Yoon, B. S. Kim

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective: Extracorporeal shockwave therapy (ESWT) has been shown to have chondroprotective effects on arthritic diseases. We investigated the effects of ESWT on temporomandibular joint osteoarthritis (TMJOA) using rat chondrocytes and TMJOA rat models. Design: Cell viability and expression of pro-inflammatory cytokines, cartilage degradation, and apoptosis markers were measured in control, monosodium iodoacetate (MIA)-treated and ESWT plus MIA-treated chondrocytes in vitro, and intra-articular MIA injection (TMJOA) and ESWT on TMJOA rats in vivo. In vivo 99mTc-hydroxymethylene diphosphonate (HDP) single-photon emission computerized tomography/computerized tomography (SPECT/CT) and ex-vivo micro-CT and histologic examinations were performed in rat models. Results: ESWT plus MIA-treated chondrocytes showed increased cell viability significantly (P = 0.007), while decreased genetic expression of pro-inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6); P < 0.001 for each] and cartilage degradation markers [matrix metalloproteinase-3 (MMP3), matrix metalloproteinase-13 (MMP13), and bone morphogenetic protein 7 (BMP7); P < 0.001 for each], and number of apoptotic cells (P < 0.001) compared to MIA-treated chondrocytes. Changes in cytochrome c and cleaved caspase-3 levels relative to procaspase-3 were decreased over MIA-treated chondrocytes. ESWT on TMJOA rat models was associated with a significant decrease in pro-inflammatory and cartilage degradation markers, as demonstrated by real-time PCR and immunohistochemistry stains (P < 0.001 for each). On 99mTc-HDP SPECT/CT, the ESWT group showed a significantly lower uptake ratio compared to the TMJOA group (P = 0.008). Micro-CT analysis revealed that the ESWT group showed improved structure and bone quality compared to the TMJOA control group. Conclusions: ESWT was associated with a protective effect on cartilage and subchondral bone structures of TMJOA by reducing inflammation, cartilage degradation, and chondrocyte apoptosis.

Original languageEnglish
Pages (from-to)1692-1701
Number of pages10
JournalOsteoarthritis and Cartilage
Issue number11
StatePublished - Nov 2019

Bibliographical note

Funding Information:
This research was supported by RP-Grant 2018 of Ewha Womans University ( 2018-0001-001-1 , Bom Sahn Kim) and Basic Science Research Program through the National Research Foundation of Korea ( 2015R1C1A2A01054113 and 2018R1D1A1B07049400 , Hai-Jeon Yoon; 2018R1D1A1B07045321 , Bom Sahn Kim; 2018R1D1A1B07045394 , Yemi Kim). The funding sources had no role in the study design, data collection or analysis, interpretation of data, writing of the manuscript, or in the decision to submit the manuscript for publication.

Publisher Copyright:
© 2019 Osteoarthritis Research Society International


  • Chondrocytes
  • Extracorporeal shock wave
  • Micro CT
  • Single photon emission computed tomography
  • Technetium 99m hydroxyethylene-diphosphonate
  • Temporomandibular joint osteoarthritis


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