Evidence map›Paper›PMID 29232698›Full record

ArticlePloS one2017

Low-energy extracorporeal shockwave therapy (ESWT) improves metaphyseal fracture healing in an osteoporotic rat model.

Gina A Mackert, Matthias Schulte, Christoph Hirche, Dimitra Kotsougiani, Julian Vogelpohl, Bernd Hoener, Teresa Fiebig, Stefanie Kirschner, Marc A Brockmann, Marcus Lehnhardt and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Extracorporeal shockwave therapy in bone fractures: a systematic review.Archives of orthopaedic and trauma surgery · 2026
    Pooled it
  2. Pooled it
  3. The effects of extracorporeal shockwave therapy on the lumbar spine of osteoporotic rat models.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Gina A MackertDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.ORCID http://orcid.org/0000-0001-6812-8025
Matthias SchulteDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Christoph HircheDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Dimitra KotsougianiDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Julian VogelpohlDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Bernd HoenerDepartment of Social- and Legal Sciences, SRH University Heidelberg, Heidelberg, Germany.
Teresa FiebigDepartment of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim, Germany.
Stefanie KirschnerDepartment of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Marc A BrockmannDepartment of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Marcus LehnhardtDepartment of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG Hospital Bergmannsheil, University Hospital Bochum, Bochum, Germany.
Ulrich KneserDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Leila HarhausDepartment of Hand-, Plastic and Reconstructive Surgery, Burn Center, Department of Plastic Surgery of the University of Heidelberg, BG Trauma Center, Ludwigshafen, Germany.
Heidelberg University · DEJohannes Gutenberg University Mainz · DEBG University Hospital Bergmannsheil Bochum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAs result of the current demographic changes, osteoporosis and osteoporotic fractures are becoming an increasing social and economic burden. In this experimental study, extracorporeal shock wave therapy (ESWT), was evaluated as a treatment option for the improvement of osteoporotic fracture healing.

methodsA well-established fracture model in the metaphyseal tibia in the osteoporotic rat was used. 132 animals were divided into 11 groups, with 12 animals each, consisting of one sham-operated group and 10 ovariectomized (osteoporotic) groups, of which 9 received ESWT treatment. Different energy flux intensities (0.15 mJ/mm2, 0.35 mJ/mm2, or 0.55 mJ/mm2) as well as different numbers of ESWT applications (once, three times, or five times throughout the 35-day healing period) were applied to the osteoporotic fractures. Fracture healing was investigated quantitatively and qualitatively using micro-CT imaging, quantitative real-time polymerase chain reaction (qRT-PCR) analysis, histomorphometric analysis and biomechanical analysis.

resultsThe results of this study show a qualitative and quantitative improvement in the osteoporotic fracture healing under low-energy (energy flux intensity: 0,15 mJ/mm2) ESWT and with fewer treatment applications per healing period.

conclusionIn conclusion, low-energy ESWT seems to exhibit a beneficial effect on the healing of osteoporotic fractures, leading to improved biomechanical properties, enhanced callus-quantity and -quality, and an increase in the expression of bone specific transcription factors. The results suggest that low-energy ESWT, as main treatment or as adjunctive treatment in addition to a surgical intervention, may prove to be an effective, simple to use, and cost-efficient option for the qualitative and quantitative improvement of osteoporotic fracture healing.

Indexed as

Disease Models, AnimalExtracorporeal Shockwave TherapyFracture HealingAnimalsFemaleOsteoporotic FracturesRatsRats, Sprague-Dawley

Identifiers

PMID29232698
PMCPMC5726728
OpenAlexW2772054142

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.