Radial Extracorporeal Shockwave Therapy Reduces Subchondral Osteoblast Senescence in Knee Osteoarthritis.

This article investigates the therapeutic potential of radial extracorporeal shockwave therapy (rESWT) in early-stage knee osteoarthritis (OA), focusing on its effects on subchondral bone (SCB) osteoblast senescence and bone turnover. Using a rat model of monosodium iodoacetate (MIA)–induced OA and human SCB samples, the study found that osteoblast senescence contributes to increased SCB turnover in early OA, and that rESWT at an optimal dose (0.096 mJ/mm²) mitigates cartilage degradation, improves SCB microarchitecture, reduces osteoblast senescence, stabilizes the cell cycle, and decreases oxidative stress. Comparisons with treadmill exercise (TE) showed that rESWT's therapeutic effects were comparable, with no additional benefit from combining the two treatments, suggesting rESWT may serve as a supplementary or alternative therapy, especially for patients contraindicated for exercise. The study highlights the need for further research to clarify the molecular mechanisms underlying rESWT's effects and to optimize clinical applications.