Application of shear wave elastography and B-mode ultrasound in patellar tendinopathy after extracorporeal shockwave therapy

2019 ◽  
Vol 47 (3) ◽  
pp. 469-476 ◽  
Author(s):  
Cici Zhang ◽  
Lixia Duan ◽  
Qiong Liu ◽  
Wen Zhang
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Patellar Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

scholarly journals Focused Extracorporeal Shockwave Therapy in Physical Medicine and Rehabilitation

2020 ◽  
Author(s):  
Richard Crevenna ◽  
Michael Mickel ◽  
Othmar Schuhfried ◽  
Christina Gesslbauer ◽  
Andrej Zdravkovic ◽  
...  
Keyword(s):  
Pain Syndrome ◽  
Surrounding Tissue ◽  
Patellar Tendinopathy ◽  
Physical Medicine ◽  
Physical Treatment ◽  
Extracorporeal Shockwave Therapy ◽  
Non Union ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Physical Medicine And Rehabilitation

Abstract Purpose of Review Focused extracorporeal shockwave therapy (fESWT) is a physical treatment modality developed over the last 25 years for musculoskeletal indications. It has many indications in the field of physical medicine and rehabilitation (PM&R) and is effective, time-efficient, and cost-efficient. This review focuses on basics and on clinical indications as well as on significant trends in fESWT. Recent Findings In PM&R, stimulation of healing processes in tendons, surrounding tissue, and bones via mechanotransduction seems to be a relevant biological effect. The International Society for Medical Shockwave Treatment (ISMST) describes different types of indications (such as approved standard indications—in accordance with most scientific evidence—like calcifying tendinopathy of the shoulder, plantar fasciitis lateral epicondylopathy of the elbow, greater trochanter pain syndrome, patellar tendinopathy, Achilles tendinopathy and bone non-union, common empirically tested clinical uses, exceptional or expert indications, and experimental indications). Summary fESWT is a relevant treatment option in PM&R and regenerative medicine. In recent years, historical paradigms (for example, application in cancer patients) have changed and new indications (such as nerve regeneration, myofascial trapezius syndrome, low back pain, dermatosclerosis, and lymphedema) are supported. Future translational research should focus on establishing actual exceptional indications and experimental indications for clinical routine.

The TOPGAME-study: effectiveness of extracorporeal shockwave therapy in jumping athletes with patellar tendinopathy

2011 ◽  
Vol 45 (6) ◽  
pp. 537-538 ◽  
Author(s):  
J. Zwerver ◽  
I. van den Akker-Scheek ◽  
F. Hartgens ◽  
H. van de Worp ◽  
E. Verhagen ◽  
...  
Keyword(s):  
Patellar Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

A Narrative Review Evaluating Extracorporeal Shockwave Therapy as a Potential Regenerative Treatment for Musculoskeletal Conditions in Military Personnel

2021 ◽  
Author(s):  
Hannah K Steere ◽  
Stephanie DeLuca ◽  
Joanne Borg-Stein ◽  
Gerard A Malanga ◽  
Adam S Tenforde
Keyword(s):  
Lower Extremity ◽  
Military Personnel ◽  
Platelet Rich Plasma ◽  
Musculoskeletal Injuries ◽  
Patellar Tendinopathy ◽  
Military Population ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
The Military

ABSTRACT Introduction Extracorporeal shockwave therapy (ESWT) has a wide variety of clinical applications ranging from urology to orthopedics. Extracorporeal shockwave therapy is of particular interest to military medicine in the treatment of diverse musculoskeletal injuries, including recalcitrant tendinopathy. Much of the evidence for ESWT is from studies in the civilian population, including athletes. A few investigations have been conducted within military personnel. Musculoskeletal conditions within military personnel may contribute to pain and physical limitations. Optimal functional outcomes could be achieved through ESWT. The purpose of this narrative review is to summarize the current evidence on the efficacy of ESWT the in management of lower extremity musculoskeletal injuries in the military. Further, we explore the relative efficacy of ESWT compared to regenerative medicine procedures, including studies with treatment using platelet-rich plasma. Materials and Methods A literature review was performed in April 2020 to identify studies evaluating the use of ESWT for lower extremity conditions commonly observed in military personnel, including plantar fasciitis, Achilles tendinopathy, patellar tendinopathy, medial tibial stress syndrome, and knee arthritis. The literature search was completed by two researchers independently, using PubMed and Embase databases and same search terms. Disagreements were adjudicated by a senior author. Due to the paucity of relevant search results, the search term parameters were expanded to incorporate active participants. Results Two studies evaluated the use of ESWT in a military population for lower extremity injuries. This included a randomized control trial in active military with medial tibial stress syndrome and an unblinded retrospective study for the chronic plantar fasciitis condition. Both studies in the military had favorable outcomes in the use of ESWT compared to other treatment arms. The remaining studies predominantly included athletes. Although heterogeneity on the quality of the studies may prevent meta-analysis and limit the generalization of the findings, the majority of studies demonstrated an improvement in pain and return to activity using ESWT. Two studies using platelet-rich plasma as a treatment arm identified similar short-term outcomes compared to ESWT for Achilles tendinopathy and patellar tendinopathy. Conclusion Our findings suggest that ESWT is a safe and well-tolerated intervention with positive outcomes for lower extremity conditions commonly seen in the military. The few studies comparing ESWT to PRP suggest regenerative benefits similar to orthobiologics in the shorter term. More robust quality designed research may enable the evaluation of ESWT efficacy within the military population. In summary, the use of ESWT may provide pain reduction and improved function in active populations with lower extremity musculoskeletal injuries. Further research in the military is needed to evaluate shockwave efficacy in order to advance musculoskeletal care and improve outcomes.

Extracorporeal Shockwave for Chronic Patellar Tendinopathy

2007 ◽  
Vol 35 (6) ◽  
pp. 972-978 ◽  
Author(s):  
Ching-Jen Wang ◽  
Jih-Yang Ko ◽  
Yi-Sheng Chan ◽  
Lin-Hsiu Weng ◽  
Shan-Lin Hsu
Keyword(s):  
Patellar Tendon ◽  
Group Versus ◽  
Patellar Tendinopathy ◽  
Control Group ◽  
Study Group ◽  
Extracorporeal Shockwave Therapy ◽  
Ultrasonographic Examination ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background Chronic patellar tendinopathy is an overuse syndrome with pathologic changes similar to tendinopathies of the shoulder, elbow, and heel. Extracorporeal shockwave was shown effective in many tendinopathies. Hypothesis Extracorporeal shockwave therapy may be more effective than conservative treatment for chronic patellar tendinopathy. Study Design Randomized controlled clinical trial; Level of evidence, 2. Methods This study consisted of 27 patients (30 knees) in the study group and 23 patients (24 knees) in the control group. In the study group, patients were treated with 1500 impulses of extracorporeal shockwave at 14 KV (equivalent to 0.18 mJ/mm 2 energy flux density) to the affected knee at a single session. Patients in the control group were treated with conservative treatments including nonsteroidal anti-inflammatory drugs, physiotherapy, exercise program, and the use of a knee strap. The evaluation parameters included pain score, Victorian Institute of Sports Assessment score, and ultrasonographic examination at 1, 3, 6, and 12 months and then once a year. Results At the 2- to 3-year follow-up, the overall results for the study group were 43% excellent, 47% good, 10% fair, and none poor. For the control group, the results were none excellent, 50% good, 25% fair, and 25% poor. The mean Victorian Institute of Sports Assessment scores were 42.57 ± 10.22 and 39.25 ± 10.85, respectively, before treatment (P = .129) and 92.0 ± 10.17 and 41.04 ± 10.96, respectively, after treatment (P < .001). Satisfactory results were observed in 90% of the study group versus 50% of the control group (P < .001). Recurrence of symptoms occurred in 13% of the study group and 50% of the control group (P = .014). Ultrasonographic examination showed a significant increase in the vascularity of the patellar tendon and a trend of reduction in the patellar tendon thickness after shockwave treatment compared with conservative treatments. However, no significant difference in the appearance, arrangement, and homogeneity of tendon fibers was noted between the 2 groups. There were no systemic or local complications or device-related problems. Conclusion Extracorporeal shockwave therapy appeared to be more effective and safer than traditional conservative treatments in the management of patients with chronic patellar tendinopathy.

scholarly journals Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations, and Future Directions

2020 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Tendon Healing ◽  
Patellar Tendinopathy ◽  
Current Evidence ◽  
Future Research ◽  
Future Directions ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Research Findings ◽  
And Performance

Tendinopathy is a chronic degenerative tendon disorder which is characterised by pain, swelling and impaired physical function and performance, presenting in both athletes and the general population. Extracorporeal shockwave therapy (ESWT) is an increasingly common treatment for tendinopathy, which can initiate tendon healing and regeneration. The review presents current understanding of mechanisms of action of ESWT and provides a brief overview of its history and development. The central purpose of the review is to synthesise research findings investigating the effectiveness of ESWT for seven common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, gluteal, hamstring and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT is effective and can be recommended in treatment for the seven tendinopathies. However, the evidence is stronger for certain tendinopathies compared to others and uncertainties remain regarding the optimal ESWT treatment parameters. The consensus from recent literature is that although ESWT can be effective in isolation it should be combined with other treatments in tendinopathy, which needs to be addressed in future research.

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