Bilgin Halil, Yüksel Özkan, Yavuz Akalın, Nazan Çevik, Alpaslan Öztürk

Comparison of the effects of hyperbaric oxygen and extracorporeal shock wave therapy on healing in osteotendinousjunctional injuries: an experimental study of the rabbit model

Objectives: To biomechanically and histopathologically compare the effects on healing in the osteotendinousregion of the treatment methods of hyperbaric oxygen (HBO) and extracorporel shock wave (ESW) on aninjury created at the osteotendinous junction in an experimental rabbit model.Methods: The study included 36 New Zealand rabbits. The patellar tendon tibial osteotendinous junction wascut and then repaired. Group 1 was evaluated as the control group, with no further intervention. In Group 2, asingle session of ESW was applied at 14 hz/750 Impulse/10 mins to an area 1×1 cm2 in the repaired area underfluoroscopy guidance. The animals in Group 3 were applied with 100% oxygen as HBO at 2.4 ATA/110 minfor 7 days. At the end of 6 weeks, 6 animals from each group were applied with a tension test and 6 animalswere processed for histopathological examination.Results: In Group 1, the forces at the start of the separation of the osteotendinous junction, at a 2 mm separationand at full rupture were lower than those of Group 2 and Group 3 (p = 0.001 and p = 0.001, respectively). Thehighest separation force values were determined in Group 3 (p = 0.001). Histopathologically, a statisticallysignificant difference was determined in respect of the fibrocartilage tisssue formation, and fusion with newbone tissue between Group 1 and Group 2 and between Group 1 and Group 3 (p < 0.05). No statisticallysignificant difference was determined between Group 2 and Group 3 (p = 0.310).Conclusions: It was observed that the application of HBO and ESW improved biomechanical resistance andhealing in the injuries in the osteotendinous junction by increasing the bone-tendon fusion in this area. Theapplication of HBO and ESW increased biomechanical resistance compared to the control group.In thehistopathological evaluation, the ESW group was better than the control group and the HBO group wasevaluated as the best.

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