Ching-Jen Wang, Chung-Cheng Huang, Hon-Kan Yip, Ya-Ju Yang

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Dosage effects of extracorporeal shockwave therapy in early hip necrosis Ching-Jen Wang, Chung-Cheng Huang, Hon-Kan Yip, Ya-Ju Yang International Journal of Surgery Volume 35, Pages 179-186 (November 2016) DOI: 10.1016/j.ijsu.2016.09.013 Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 1 a shows pain score and Harris hip score before treatment (PRE) and in 6, 12 and 24 months after treatment. b shows serum nitrate (NO3) and VEGF levels before treatment (PRE) and in 1 week, 1, 3 and 6 months after treatment. Group A: 10 patients with 16 hips, Group B: 11 patients with 14 hips and Group C: 12 patients with 12 hips. The P value < 0.05 is considered statistically significant. *Significant difference as assessed by Wilcoxon Signed Ranks test. #Significant difference as analyzed using the Mann-Whitney tests with Bonferroni correction. International Journal of Surgery 2016 35, 179-186DOI: (10.1016/j.ijsu.2016.09.013) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 2 a shows serum BMP-2 and osteocalcin levels, and b shows serum TNF-α and IL-6 levels before treatment (PRE) and in 1 week, 1, 3 and 6 months after treatment. Group A: 10 patients with 16 hips, Group B: 11 patients with 14 hips and Group C: 12 patients with 12 hips. The P value < 0.05 is considered statistically significant. *Significant difference as assessed by Wilcoxon Signed Ranks test. #Significant difference as analyzed using the Mann-Whitney tests with Bonferroni correction. International Journal of Surgery 2016 35, 179-186DOI: (10.1016/j.ijsu.2016.09.013) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 3 a shows serum substance P and CGRP levels, and b shows serum DKK-1 and IGF levels before treatment (PRE) and at 1 week, 1, 3 and 6 months after treatment. Group A: 10 patients with 16 hips, Group B: 11 patients with 14 hips and Group C: 12 patients with 12 hips. The P value < 0.05 is considered statistically significant. *Significant difference as assessed by Wilcoxon Signed Ranks test. #Significant difference as analyzed using the Mann-Whitney tests with Bonferroni correction. International Journal of Surgery 2016 35, 179-186DOI: (10.1016/j.ijsu.2016.09.013) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions

Fig. 4 Shows microcirculatory dynamic contrast-enhanced MR imagine before treatment (PRE) and 6 months after treatment. All paired samples of Ktrans and Vp in the peri-necrotic areas were significantly greater than the corresponding necrotic areas of the femoral heads in all three groups (all P < 0.05). Group A: 10 patients with 16 hips, Group B: 11 patients with 14 hips and Group C: 12 patients with 12 hips. The P value < 0.05 is considered statistically significant. Ktrans: volume transfer constant. Vp: plasma volume per unit volume of tissue. *Significant difference as assessed by Wilcoxon Signed Ranks test. #Significant difference as analyzed using the Mann-Whitney tests with Bonferroni correction. International Journal of Surgery 2016 35, 179-186DOI: (10.1016/j.ijsu.2016.09.013) Copyright © 2016 IJS Publishing Group Ltd Terms and Conditions