Title:Extracorporeal Shock Wave Therapy as Regenerative Medicine in
Knee Osteoarthritis: Pre-Experiment for Matrix Metalloproteinase-3
Evaluation
Volume: 20
Issue: 2
Author(s): Amandha Boy Timor Randita, Indrayuni Lukitra Wardhani*, Andriati Andriati, Nurul Kusuma Wardani, Petrina Theda Philothra, Imam Subadi and Soenarnatalina Melaniani
Affiliation:
- Department of Physical Medicine and Rehabilitation, Faculty of
Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Keywords:
Knee osteoarthritis, extracorporeal shock wave therapy, matrix metalloproteinase-3, degenerative diseases, regenerative medicine, kellergren lawrence.
Abstract:
Background: Knee osteoarthritis (KOA) is currently treated by regenerative therapies
that aim to inhibit arthritic degeneration. Extracorporeal shock wave therapy (ESWT) is one of the
physical regenerative approaches used for KOA management. However, little is known regarding
the impact of shock wave treatment on matrix metalloproteinase-3 (MMP-3), which is one of the
enzymes mediating cartilage degradation.
Objectives: To evaluate the effect of ESWT on MMP-3 levels and pain intensity in patients with
KOA.
Methods: Fourteen patients diagnosed with Kellgren Lawrence, grades 2 and 3 KOA were recruited
for the study. ESWT piezo shockwave was applied once a week for six weeks. MMP-3 levels
in the blood were measured pre-test, mid-test (three weeks after therapy) and post-test (one week
after the last session) by enzyme-linked immunosorbent assay (ELISA). The perceived pain was
recorded at each session by the Wong Becker Face Scale.
Results: The median pre-test, mid-test and post-test MMP-3 levels were 19.92 ng/mL, 15.89
ng/mL and 18.82 ng/mL, respectively, and there were significant differences between the pre-test
and mid-test, and the pre-test and post-test values (p < 0.05). The pain scores also decreased significantly
over the period of intervention.
Conclusion: MMP-3 levels decreased significantly in KOA patients after ESWT, and the decline
was most obvious after 3 weeks of therapy. Therefore, EWST should be considered as a suitable
treatment option for KOA.
