scholarly journals Historical ESWT Paradigms Are Overcome: A Narrative Review

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Heinz Lohrer ◽  
Tanja Nauck ◽  
Vasileios Korakakis ◽  
Nikos Malliaropoulos
Keyword(s):  
Energy Intensity ◽  
Extracorporeal Shock Wave Therapy ◽  
Lesion Size ◽  
Consensus Meeting ◽  
Narrative Review ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Acute Injuries ◽  
Current Perspective ◽  
A Current

Extracorporeal Shock Wave Therapy (ESWT) is a conservative treatment modality with still growing interest in musculoskeletal disorders. This narrative review aims to present an overview covering 20-year development in the field of musculoskeletal ESWT. Eight historical paradigms have been identified and put under question from a current perspective: energy intensity, focus size, anesthesia, imaging, growth plates, acuteness, calcifications, and number of sessions. All paradigms as set in a historical consensus meeting in 1995 are to be revised. First, modern musculoskeletal ESWT is divided into focused and radial technology and the physical differences are about 100-fold with respect to the applied energy. Most lesions to be treated are easy to reach and clinical focusing plays a major role today. Lesion size is no longer a matter of concern. With the exception of nonunion fractures full, regional, or even local anesthesia is not helpful in musculoskeletal indications. Juvenile patients can also effectively be treated without risk of epiphyseal damage. Further research is needed to answer the question about if and which acute injuries can be managed effectively. Treatment parameters like the number of sessions are still relying on empirical data and have to be further elucidated.

The evaluation of extracorporeal shock wave therapy on collagenase induced superficial digital flexor tendonitis

2006 ◽  
Vol 19 (02) ◽  
pp. 99-105 ◽  
Author(s):  
K. D. Kersh ◽  
D. Van Sickle ◽  
R. B. Evans ◽  
S. R. McClure
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Lesion Size ◽  
Carpal Bone ◽  
Shock Wave Therapy ◽  
Grey Scale ◽  
Extracorporeal Shock Wave ◽  
Superficial Digital Flexor Tendon ◽  
Heat Response ◽  
And Control

SummaryExtracorporeal shock wave therapy (ESWT) is being used to treat desmitis and tendonitis in horses. This paper compares the clinical, ultrasonographic and histological characteristics of ESWT treated collagenase induced superficial digital flexor tendon (SDFT) lesions, versus untreated controls. This blinded study utilizes six mature, healthy horses where bilateral forelimb SDFT lesions were induced. One forelimb was treated while the other served as an untreated control. Three shock wave treatments were administered at three week intervals. At weekly intervals, ultrasonograms were used to measure: 1) percentage lesion at the maximum injury zone (MIZ), 2) the grey scale of the SDFT at the MIZ, 3) the percentage disruption of the longitudinal fibres at the MIZ. The data were also summed from 8–20 cm distal to the accessory carpal bone. Measurements of the external width of the SDFT were obtained through the study period. Examinations were performed on four occasions to evaluate heat, response to palpation, presence/character of swelling over the SDFT, and lameness. At the completion of the study all tendons were evaluated histologicalally. The lesion size, grey scale, and longitudinal fibre disruption at the MIZ, and sum of each variable changed significantly over time, however, there was no difference between treated and control groups. Histopathology showed increased neovascularization in treated tendons (p = 0.001). When compared to untreated controls, ESWT did not change the ultrasonographic appearance of the tendons. However, it did increase neovascularization.

scholarly journals High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Fuqiang Gao ◽  
Wei Sun ◽  
Zirong Li ◽  
Wanshou Guo ◽  
Weiguo Wang ◽  
...  
Keyword(s):  
Shock Wave ◽  
Femoral Head ◽  
Early Stage ◽  
Case Series ◽  
Extracorporeal Shock Wave Therapy ◽  
High Energy ◽  
Lesion Size ◽  
Harris Hip Score ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score,P=0.00006; Harris hip score,P=0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group,P=0.091; non-LPFH group,P=0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group,P=0.007; non-LPFH group,P=0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

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