臨床整形外科56巻3号

2021年03月発行

特集 骨折に対する積極的保存療法 基礎編

高齢マウス骨折モデル，ラット骨折モデルにおける低出力超音波パルス照射の効果

著者： 成瀬康治¹

所属機関： ¹医療法人社団萌寿会東林間整形外科

ページ範囲：P.227 - P.231

　高齢マウス骨折モデル，高齢ラット骨折モデルを用いて，加齢(エイジング)により骨折治癒が遅延することを示した．この骨折モデルによって内軟骨性骨化から硬性仮骨架橋までに要する期間が遷延することで骨折治癒が遅延することを明らかにした．低出力超音波パルスはエイジングによって生じる遷延治癒を促進し，特に内軟骨性骨化とリモデリングにかかる期間を短縮できることが示された．その機序の一端には骨折部周囲に生じる新生血管の発現増加が関与していることが推測された．

参考文献

1) Maintz G. Animal experiments in the study of the effect of ultrasonic waves on bone regeneration. Strahlentherapie 1950;82(4):631-8. [Article in Undetermined Language]

2) Bender LF, Janes JM, Herrick JF. Histologic studies following exposure of bone to ultrasound. Arch Phys Med Rehabil 1954;35(9):555-9.

3) Herrick JF, Janes JM, Ardan NI Jr. Experimental studies relative to the therapeutic use of ultrasound. J Am Vet Med Assoc 1956;128(12):571-7.

4) Ardan NI Jr, Janes JM, Herrick JF. Ultrasonic energy and surgically produced defects in bone. J Bone Joint Surg Am 1957;39-A(2):394-402.

5) Duarte LR. The stimulation of bone growth by ultrasound. Arch Orthop Trauma Surg 1983;101(3):153-9.

6) Xavier CA, Duarte LR. Ultrasonic stimulation of bone callus:clinical application. Rev Bras Ortop 1983;18:73-80.

7) Wells PNT. Ultrasonic imaging of the human body. Rep Prog Phys 1999;62(5):671-722.

8) Parvis J, Harris SJ, Pounder NM. Low-intensity ultrasound and fracture healing:a proposed mechanism of action. In:Aaron RK, Bolander ME(ed). Physical Regulation of Skeletal Repair. Chicago:American Academy of Orthopedic Surgeons;2005. p.85-96.

9) Park K, Hoffmeister B, Han DK, et al. Therapeutic ultrasound effects on interleukin-1β stimulated cartilage construct in vitro. Ultrasound Med Biol 2007;33(2):286-95.

10) Iwabuchi S, Ito M, Hata J, et al. In vitro evaluation of low-intensity pulsed ultrasound in herniated disc resorption. Biomaterials 2005;26(34):7104-14.

11) Wang SJ, Lewallen DG, Bolander ME, et al. Low intensity ultrasound treatment increases strength in a rat femoral fracture model. J Orthop Res 1994;12(1):40-7.

12) Yang KH, Parvizi J, Wang SJ, et al. Exposure to low-intensity ultrasound increases aggrecan gene expression in a rat femur fracture model. J Orthop Res 1996;14(5):802-9.

13) 神宮司誠也，岩本幸英，東　由明・他．ラット大腿骨骨折治癒への低出力超音波パルス照射の効果．骨折1999；21(2)：655-8．

14) Azuma Y, Ito M, Harada Y, et al. Low-intensity pulsed ultrasound accelerates rat femoral fracture healing by acting on the various cellular reactions in the fracture callus. J Bone Miner Res 2001;16(4):671-80.

15) Pilla AA, Mont MA, Nasser PR, et al. Non-invasive low-intensity pulsed ultrasound accelerates bone healing in the rabbit. J Orthop Trauma 1990;4(3):246-53.

16) Gebauer GP, Lin SS, Beam HA, et al. Low-intensity pulsed ultrasound increases the fracture callus strength in diabetic BB Wistar rats but does not affect cellular proliferation. J Orthop Res 2002;20(3):587-92.

17) Takikawa S, Matsui N, Kokubu T, et al. Low-intensity pulsed ultrasound initiates bone healing in rat nonunion fracture model. J Ultrasound Med 2001;20(3):197-205.

18) Erdogan O, Esen E, Ustün Y, et al. Effects of low-intensity pulsed ultrasound on healing of mandibular fractures:an experimental study in rabbits. J Oral Maxillofac Surg 2006;64(2):180-8.

19) Li J, Waugh LJ, Hui SL, et al. Low-intensity pulsed ultrasound and nonsteroidal anti-inflammatory drugs have opposing effects during stress fracture repair. J Orthop Res 2007;25(12):1559-67.

20) Naruse K, Sekiya H, Harada Y, et al. Prolonged endochondral bone healing in senescence is shortened by low-intensity pulsed ultrasound in a manner dependent on COX-2. Ultrasound Med Biol 2010;36(7):1098-108.

21) Katano M, Naruse K, Uchida K, et al. Low intensity pulsed ultrasound accelerates delayed healing process by reducing the time required for the completion of endochondral ossification in the aged mouse femur fracture model. Exp Anim 2011;60(4):385-95.

22) Lu C, Miclau T, Hu D, et al. Cellular basis for age-related changes in fracture repair. J Orthop Res 2005;23(6):1300-7.

23) Maes C, Carmeliet P, Moermans K, et al. Impaired angiogenesis and endochondral bone formation in mice lacking the vascular endothelial growth factor isoforms VEGF164 and VEGF188. Mech Dev 2002;111(1-2):61-73.

24) Mayr-Wohlfart U, Waltenberger J, Hausser H, et al. Vascular endothelial growth factor stimulates chemotactic migration of primary human osteoblasts. Bone 2002;30(3):472-7.

25) Meyer RA Jr, Meyer MH, Tenholder M, et al. Gene expression in older rats with delayed union of femoral fractures. J Bone Joint Surg Am 2003;85(7):1243-54.

26) Meyer RA Jr, Tsahakis PJ, Martin DF, et al. Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats. J Orthop Res 2001;19(3):428-35.

27) Naruse K, Miyauchi A, Itoman M, et al. Distinct anabolic response of osteoblast to low-intensity pulsed ultrasound. J Bone Miner Res 2003;18(2):360-9.