Objective To investigate the effect and mechanism of extracorporeal shock wave therapy(ESWT)on inflammatory factors in synovial and cartilage tissues of the rats with knee osteoarthritis(KOA).Methods Thirty male Sprague Dawley(SD)rats were randomly divided into the control group,the model group and the shock wave group.The control group were injected with 50 μL normal saline in the right joint cavity,and the model group and shock wave group were injected with 2 mg/50 μL mono2-iodoacetate(MIA)in the right knee cavity to construct KOA models.After the intervention for 14 days,the control group and the model group received shock wave sound stimulation,and the shock wave group were treated with ESWT once a week for 4 weeks.The paw withdrawal thermal latency(PWTL)and the mechanical withdrawal threshold(MWT)of the right posterior paw were measured by Thermal stimulator and plantar sting apparatus 3,7,14,21,28,35,and 42 days before and after operation respectively.On the 42nd day after operation,all rats were anesthetized by intraperitoneal injection of 10％chloral hydrate,X-ray examination of right knee joint was performed,and then killed and the right knee joint removed.The expressions of interleukin-1 β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in synovium and cartilage of knee joint were detected by immunohistochemical method(IHC).Results The PWTL of the model group and shock wave group was shorter than that of the control group on the 3r1 to 42ndday after surgery(P＜0.05),and PWTL of the shock wave group was longer on the 28st and 42nd day than that of the model group(P＜0.05).The MWT of the model group and shock wave group was lower than that in the control group on the 3rd to 42nd day after surgery(P＜0.05),and MWT of the shock wave group was higher than that in the model group on the 21st and 42nd day after surgery(P＜0.05).Compared with the control group,the joint space of the model group and the shock wave group was more narrow,the joint surface was rough and deformed more severely,the alignment of the knee joint was uneven,and osteophytes were formed at the joint edge.The X-ray findings in the shock wave group were lighter than those in the model group.The levels of TNF-α,IL-1β,and IL-6 in synovial and cartilage tissues of knee joint of the 3 groups were as follow:the control group＜shock wave group＜model group(P＜0.05).Conclusion ESWT can alleviate pain sensitization symptoms and the progression of KOA in rats,and the mechanism may be related to the decrease of IL-1β,IL-6,and TNF-α expression in synovium and cartilage.
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