Addition of shock wave therapy to nail dynamization increases the chance of long-bone non-union healing

Abstract Background Long-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions. Materials and methods 49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union. Results Union rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009–1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000–0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717–0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051–2425.038; p = 0.009). Conclusions Data from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone. Level of evidence Level 3.

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Extracorporeal Shock Wave Therapy for the Treatment of Non-Union of a Canine Mandibular Fracture

VCOT Open ◽

10.1055/s-0039-3400617 ◽

2019 ◽

Vol 02 (02) ◽

pp. e56-e59

Author(s):

Olivia J. Oginska ◽

Richard Whitelock ◽

Kirsten Hausler ◽

Amy Stelman ◽

Matthew J. Allen

Keyword(s):

Shock Wave ◽

Case Report ◽

Bone Fractures ◽

Extracorporeal Shock Wave Therapy ◽

Mandibular Fracture ◽

Long Bone ◽

Clinical Use ◽

Shock Wave Therapy ◽

Non Union ◽

Extracorporeal Shock Wave

AbstractThe use of extracorporeal shock wave therapy (ESWT) for the treatment of delayed or non-union of long bone fractures has been described in human patients with encouraging results. This case report describes the successful treatment of a mandibular fracture non-union with ESWT. To authors' knowledge, this is the first report of the clinical use of ESWT for the management of a non-union in a dog.

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Effects of Clinicopathological Characteristics on the Survival of Patients Treated with PD-1/PD-L1 Inhibitor Monotherapy or Combination Therapy for Advanced Cancer: A Systemic Review and Meta-Analysis

Journal of Immunology Research ◽

10.1155/2020/5269787 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Yuhan Wei ◽

Yongfu Li ◽

Qi Du ◽

Xinyi Peng ◽

Jiangtao Jin ◽

...

Keyword(s):

Liver Metastasis ◽

Combination Therapy ◽

Survival Benefit ◽

Malignant Tumors ◽

Smoking Status ◽

Systemic Review ◽

Wild Type ◽

Risk Of Death ◽

Significant Difference ◽

Ecog Ps

Background. PD-1/PD-L1 inhibitors have made unprecedented progress in the treatment of cancer. Methods. A systemic search was conducted for randomized controlled trials that compared PD-1/PD-L1 inhibitor monotherapy or combination therapy with nonimmunotherapy. Hazard ratios (HRs) of overall survival (OS) according to the sex, age, ECOG PS, smoking status, liver metastasis, PD-L1 expression, EGFR, and KRAS status of patients were analyzed. Results. Totally, 13 studies with monotherapy and 5 with combination regimens were included, and the pooled HRs of OS were 0.74 ( P < 0.001 ) and 0.64 ( P < 0.001 ), respectively. EGFR wild-type patients could benefit from immunotherapy monotherapy (HR, 0.77; P < 0.001 ) while those of the mutant type had no survival benefit (HR, 1.11; P = 0.54 ), and the difference was statistically significant (interaction, P = 0.005 ). KRAS wild-type patients had no survival benefit from monotherapy (HR, 0.89; P = 0.49 ). For combination therapy, both male and female derived benefits but female had a significantly reduced risk of death (HR, 0.45; P < 0.001 ) compared with male (HR, 0.73; P < 0.001 ; interaction, P = 0.004 ). Nonsmokers derived more survival benefits from combination therapy (HR, 0.29; P < 0.001 ) than smokers (HR, 0.63; P = 0.001 ; interaction, P = 0.02 ). No significant difference was found between age, ECOG PS, liver metastasis, PD-L1 expression, and OS of both PD-1/PD-L1 inhibitor monotherapy and combination therapy. Conclusions. Both PD-1/PD-L1 inhibitor monotherapy and combination therapy significantly prolonged the OS of patients with advanced malignant tumors. EGFR status for monotherapy and sex and smoking status for combination therapy were important predictors of survival benefits.

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High energy focused shock wave therapy accelerates bone healing

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-15-05-0084 ◽

2015 ◽

Vol 28 (06) ◽

pp. 425-432 ◽

Cited By ~ 17

Author(s):

N. R. Kieves ◽

C. S. MacKay ◽

K. Adducci ◽

S. Rao ◽

C. Goh ◽

...

Keyword(s):

Shock Wave ◽

Bone Healing ◽

Linear Regression Analysis ◽

Scoring Systems ◽

High Energy ◽

Delayed Union ◽

Osteotomy Site ◽

Shock Wave Therapy ◽

Sham Treatment ◽

Study Population

SummaryObjectives: To evaluate the influence of shock wave therapy (SWT) on radiographic evidence of bone healing after tibial plateau leveling osteotomy (TPLO).Methods: Healthy dogs between two to nine years of age that underwent TPLO were randomly assigned to receive either electro- hydraulic SWT (1,000 shocks) or sham treatment (SHAM). Treatment or SHAM was administered to the osteotomy site immediately postoperatively and two weeks postoperatively. Three blinded radiologists evaluated orthogonal radiographs performed eight weeks postoperatively with both a 5-point and a 10-point bone healing scale. Linear regression analysis was used to compare median healing scores between groups.Results: Forty-two dogs (50 stifles) were included in the statistical analysis. No major complications were observed and all osteo -tomies healed uneventfully. The median healing scores were significantly higher at eight weeks postoperatively for the SWT group compared to the SHAM group for the 10-point (p <0.0002) and 5-point scoring systems (p <0.0001).Clinical significance: Shock wave therapy applied immediately and two weeks post -operatively led to more advanced bone healing at the eight week time point in this study population. The results of this study support the use of electro-hydraulic SWT as a means of accelerating acute bone healing of canine osteotomies. Additional studies are needed to evaluate its use for acceleration of bone healing following fracture, or with delayed union.

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The Safety and Efficacy of High Energy Extracorporeal Shock Wave Therapy in Active, Moderately Active, and Sedentary Patients with Chronic Plantar Fasciitis

Orthopedics ◽

10.3928/0147-7447-20050701-17 ◽

2005 ◽

Vol 28 (7) ◽

pp. 685-692 ◽

Cited By ~ 10

Author(s):

John P Furia

Keyword(s):

Shock Wave ◽

Plantar Fasciitis ◽

Extracorporeal Shock Wave Therapy ◽

High Energy ◽

Shock Wave Therapy ◽

Safety And Efficacy ◽

Extracorporeal Shock Wave

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High-energy extracorporeal shock wave therapy for early stage femoral head osteonecrosis

Medicine ◽

10.1097/md.0000000000021300 ◽

2020 ◽

Vol 99 (31) ◽

pp. e21300

Author(s):

Qing-hui Ji ◽

Shi-chen Liu ◽

Jie Miao ◽

Zhi-xin Ren ◽

Yu-fei Yuan ◽

...

Keyword(s):

Shock Wave ◽

Femoral Head ◽

Early Stage ◽

Extracorporeal Shock Wave Therapy ◽

High Energy ◽

Shock Wave Therapy ◽

Extracorporeal Shock Wave ◽

Femoral Head Osteonecrosis

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High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Insertional Achilles Tendinopathy

The American Journal of Sports Medicine ◽

10.1177/0363546505281810 ◽

2006 ◽

Vol 34 (5) ◽

pp. 733-740 ◽

Cited By ~ 116

Author(s):

John Patrick Furia

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Therapy ◽

High Energy ◽

Achilles Tendinopathy ◽

Shock Wave Therapy ◽

Extracorporeal Shock Wave ◽

Insertional Achilles Tendinopathy

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Initial experience with extracorporeal shock wave therapy in six dogs – part I

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632734 ◽

2002 ◽

Vol 15 (03) ◽

pp. 177-183 ◽

Cited By ~ 14

Author(s):

P. H. Laverty ◽

S. R. McClure

Keyword(s):

Shock Wave ◽

Case Series ◽

Extracorporeal Shock Wave Therapy ◽

Invasive Technique ◽

Initial Experience ◽

Shock Wave Therapy ◽

Non Union ◽

Non Invasive ◽

Extracorporeal Shock Wave ◽

Effective Treatment Modality

SummaryExtracorporeal shock wave therapy (ESWT) may be an effective treatment modality for delayed or chronic non-union fractures. ESWT is a non-invasive technique that avoids the potential morbidity and mortality associated with traditional surgical procedures, and its use does not preclude subsequent surgical treatment. This case series demonstrates the feasibility, versatility and safety of treating dogs with ESWT.

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