Efficacy Of Extracorporeal Shock Wave Research Articles

The efficacy of extracorporeal shock wave combined with platelet rich plasma in the treatment of knee osteoarthritis with meniscus injury: A retrospective analysis.

To determine the efficacy of extracorporeal shock wave (ESW) combined with autologous platelet-rich plasma (PRP) therapy on knee osteoarthritis (KOA) with meniscus injury in terms of pain relief, functional outcome and complications. This is a retrospective observational study. Clinical data of 144 patients with KOA accompanied by medial meniscus injury, who received treatment in Jilin Provincial People's Hospital from March 2021 to December 2022, were retrospectively evaluated. A total of 128 patients (81 males and 47 females) were finally included in the study after screening. Of them, 45 patients received PRP treatment (PRP-group), 43 patients received ESW treatment (ESW-group), and 40 patients received ESW combined with PRP treatment (Combined-group). The relief of knee joint pain and functional improvement among three groups of patients were compared. After treatment, visual analogue scale (VAS), Lequesne, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores of patients in the Combined-group were significantly lower than those in the other two groups (p<0.05). Combined ESW-PRP treatment was associated with significantly greater joint range of motion of patients compared to ESW and PRP alone (p<0.05). The total incidence of related complications in the Combined-group was lower compared to the other two groups (p<0.05). Compared with PRP or ESW treatment alone, ESW combined with PRP for KOA with meniscus injury can better alleviate pain, achieve faster functional recovery, and significantly reduce complications.

Efficacy of Extracorporeal Shock Wave and Pulse Electromagnetic Field Therapies in Calcaneal Spurs.

Various treatment methods are available for calcaneal spur, which can cause disability. Objective: To evaluate the efficacy of pulsed electromagnetic field therapy (PEMFT) added to extracorporeal shock wave therapy (ESWT) on pain and functional capacity in treating calcaneal spurs. Patients with calcaneal spurs who were recommended ESWT or ESWT+PEMFT and whose Foot Function Index (FFI) and visual analogue scale (VAS) values were available in their records were retrospectively analyzed. The two groups were ESWT (n=35) and ESWT+PEMFT (n=40). FFI and VAS scores were obtained from their records before treatment, after treatment, and in the third month after treatment. The two groups were similar regarding their pre-treatment FFI and VAS scores. In intra-group evaluation, statistically significant decreases were found in terms of the FFI pain, disability, and activity limitation and VAS scores in both groups after treatment and in the third month after treatment compared to the pre-treatment period. In the comparison between the groups, the post-treatment and post-treatment third-month FFI pain, disability, and activity limitation and VAS scores were significantly lower in the PEMFT+ESWT group than the ESWT group (P<0.001). A calcaneal spur is a condition that can cause pain and functional limitation in patients. Various studies have demonstrated the efficacy of ESWT in the treatment of calcaneal spurs. In our study, we observed that PEMFT added to ESWT significantly improved the pain and functionality of the patients. Further studies are needed to evaluate the efficacy of PEMFT in calcaneal spurs.

Extracorporeal Shock Wave Combined with Warm Acupuncture for External Humeral Epicondylitis: A Randomized Clinical Trial.

The purpose of this study was to evaluate the clinical efficacy of extracorporeal shock wave combined with warm acupuncture for external humeral epicondylitis. Eighty-two patients with external humeral epicondylitis were randomly divided into an observation group and a control group. Patients in the control group were treated with extracorporeal shock waves while those in observation group with warm acupuncture on the basis of the control group. Patients in both groups were evaluated by Visual Analogue Scale (VAS), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) before and after treatment. The inflammatory factors such as IL-6, IL-10, TNF-ɑ and clinical outcomes were contrasted before and after treatment. There were statistically significant differences in VAS score, MEPS score and DASH score between the two groups before and after treatment (P<0.05), and the improvement of each score in the observation group was more obvious than that in the control group. After treatment, the inflammatory factors of the two groups were lower than those before treatment, and the difference was statistically significant (P<0.05). The decrease of inflammatory factors in the observation group was more obvious than that in the control group. The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Extracorporeal shock wave combined with warm acupuncture could effectively improve the pain symptoms and dysfunction of external humeral epicondylitis and reduce the expression of inflammatory factors, and its effect may be better than that of extracorporeal shock wave treatment alone. ChiCTR2200066075.

Clinical Efficacy of Extracorporeal Shock Wave in the Treatment of Knee Osteoarthritis： A Meta-analysis

<bold>Objective</bold> To evaluate the efficacy and safety of extracorporeal shock wave therapy for knee osteoarthritis (KOA) by Meta analysis. <bold>Methods</bold> The CNKI database, Wanfang Data, China Science and Technology Journal Database (VIP), CBMdisc, PubMed and Cochrane Library were searched from inception to October 2020 for randomized controlled trials (RCTs) of extracorporeal shock wave therapy for KOA. Outcome measures included overall efficiency, visual analogue scale (VAS), Lequesne index score, Western Ontario and McMaster University Osteoarthritis Index score (WOMAC), and incidence of adverse reactions. Literature screening and data extraction were carried out independently by two researchers, and the literature quality was evaluated according to the Cochrane Collaboration Network standard. RevMan 5.3 software was used for data analysis. Relative risk (RR) was used to analyze the binary variables; and the continuous variables with the same unit and measurement method were described by mean difference (MD), while the continuous variables with different measurement methods or units were described by standardized mean difference (SMD). The random-effects model was used for analysis when the included studies were heterogeneous (<italic>I</italic>²≥50%, <italic>P</italic>&lt;0.1), and the fixed effects model was used when the included studies were homogeneous (<italic>I</italic>²&lt;50%, <italic>P</italic>&gt;0.1). <bold>Results</bold> A total of 13 RCTs with 1 132 cases were included, 577 in the observation group and 555 in the control group. The results of meta-analysis showed that the overall efficiency of the observation group was significantly higher than that of the control group, and the difference was statistically significant [<italic>RR</italic>=1.13, 95% <italic>CI</italic>(1.05, 1.22), <italic>P</italic>=0.000 8]; the Lequesne index score of the observation group decreased more significantly after treatment than that of the control group, and the difference was statistically significant [<italic>SMD</italic>=0.68, 95% <italic>CI</italic>(0.47, 0.90), <italic>P</italic>&lt;0.000 01]; the VAS scores of the observation group were significantly lower than those of the control group after 1, 2 and 3 months of treatment, and the differences were statistically significant (<italic>P</italic>&lt;0.000 01); the decrease of WOMAC score in the observation group after 0.5, 1, 2 and 3 months treatment was more significantly than that of the control group (<italic>P</italic>&lt;0.01); there was no significant difference in the incidence of adverse reactions between the two groups [<italic>RR</italic>=0.42, 95% <italic>CI</italic>(0.13, 1.33), <italic>P</italic>=0.14]. <bold>Conclusion</bold> Extracorporeal shock wave therapy is safe and efficient in the treatment of patients with KOA, and is recommended for clinical application. Due to the quality limitations of the included studies, high-quality, multi-center RCTs with large sample size are still needed to verify the clinical effects in the future.

Extracorporeal Shock Wave Combined with Teriparatide-Loaded Hydrogel Injection Promotes Segmental Bone Defects Healing in Osteoporosis.

Osteoporosis is a systemic bone disease characterized by decreased bone density and deterioration of bone microstructure, leading to an increased probability of fragility fractures. Once segmental bone defect occurs, it is easy to cause delayed union and nonunion. The aim of this study is to investigate the efficacy of extracorporeal shock wave (ESW) and teriparatide-loaded hydrogel (T-Gel) combined strategy on the cell activity and differentiation of osteoporosis derived bone marrow mesenchymal stem cells (OP-BMSCs) in vitro and bone regeneration in osteoporotic segmental bone defects in vivo. In vitro, the strategy of combining ESW and T-Gel significantly enhanced OP-BMSCs proliferation, survival, migration, and osteogenic differentiation by up-regulating the alkaline phosphatase activity, mineralization, and expression of runt-related transcription factor-2, type I collagen, osteocalcin, and osteopontin. In the segmental bone defect models of osteoporotic rabbits, Micro-CT evaluation and histological observation demonstrated this ESW-combined with T-Gel injection significantly induced bone healing by enhancing the osteogenic activity of the local microenvironment in osteoporotic defects. In conclusion, ESW-combined with T-Gel injection could regulate the poor osteogenic microenvironment in osteoporotic defects and show potential for enhancing fragility fractures healing.

The analgesic efficacy of extracorporeal shock wave combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women

BackgroundTo explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women.MethodsThe data of postmenopausal women with osteoporotic thoracolumbar compression fracture admitted in our department from January 2017 to October 2019 were analyzed retrospectively. They were divided into groups of unipedicular percutaneous kyphoplasty (U-PKP n = 21), bipedicular PKP (B-PKP n = 20), and ESW combined with PVP after reduction in overextension position (EP-PVP n = 18). The improvement of pain and vertebral height in three groups was compared.ResultsPostoperative compression rate and Cobb angle of vertebral fractures in the three groups were all lower than those before surgery, and the differences between pre-operation and post-operation were statistically significant (P < 0.05). The visual analog scale (VAS) and Oswestry dysfunction index (ODI) scores of the three groups decreased significantly after the operation (P < 0.05). The ODI scores of the EP-PVP group in the third months after the operation were significantly improved compared with the other two groups, and the difference was statistically significant (P < 0.05).ConclusionsIn our small-sample study, all three treatment schemes can treat osteoporotic compression fracture of thoracolumbar vertebrae in postmenopausal women, relieve pain, and improve quality of life. ESW combined with PVP after reduction in overextension position could achieve a good vertebral reduction rate and improve kyphosis, and may reduce the application of analgesic drugs.

The efficacy of extracorporeal shock wave for chronic musculoskeletal pain conditions: A protocol of systematic review and meta-analysis of randomized controlled trials.

Background:This systematic review is the first one to assess the effectiveness and safety of extracorporeal shock-wave therapy (ESWT) for patients with chronic musculoskeletal pain conditions (CMPC).Methods:Seven electronic databases were searched for all relevant literature from inception to December 2019, including PubMed, the Web of Science, EMBASE, Cochrane library, China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. Only randomized controlled trials (RCTs) of ESWT for chronic musculoskeletal pain will be included. Two reviewers will independently select eligible studies and collected the detailed information, assessed the methodological quality. A third reviewer will join in discussion to solve disagreements. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) will be presented to demonstrate the effectiveness of ESWT for patients with chronic MSK pain conditions. RevMan 5.4 software will be used for statistical analysis.Results:This systematic review will explore the effectiveness and safety of ESWT for patients with CMPC. The primary outcome includes pain level, and secondary outcome includes function limitation and adverse events.Conclusion:It can provide the updated evidence which is of great importance for patients, clinical practice and health related policy maker in ESWT treating CMPC.

Extracorporeal Shock Wave Stimulates Angiogenesis and Collagen Production in Facial Soft Tissue

BackgroundThis study investigated the efficacy of extracorporeal shock wave (ESW) application in stimulating dermal thickness, vascularity, and collagen synthesis of facial skin in a large animal model. Materials and methodsThe facial skin of the maxillary and mandibular areas of goats (n = 6 per group) was treated with ESWs of different intensities (0.15 and 0.45 mJ/mm2; 1000 pulses). After 4 d, histology and immunohistochemistry were used to evaluate the following: dermal thickness, total number and abundance of microvessels, amount of type 1 collagen, and α-smooth muscle actin expression. ResultsDermal thickness, number and abundance of microvessels, and collagen synthesis increased after ESW application at both intensities (each P < 0.05). When comparing ESW groups, the highest collagen abundance was seen after 0.15 mJ/mm2 (P = 0.034), whereas the highest number of microvessels was detected after treatment with 0.45 mJ/mm2 (P = 0.002). ConclusionsA single-session application of focused low-energy ESWs to facial skin can increase dermal thickness by stimulating collagen production and local microcirculation. These findings commend the technique for future investigation for pretreatment of local or microvascular skin flaps to enhance tissue healing.

Therapeutic efficacy of extracorporeal shock wave combined with hyaluronic acid on knee osteoarthritis.

This retrospective study investigated the efficacy and safety of extracorporeal shock wave (EPSW) combined with hyaluronic acid (HA) for patients with knee osteoarthritis (KOA).This retrospective study included 70 patients with KOA. Of those subjects, 35 of them received EPSW combined HA, and were allocated to a treatment group, while the other 35 participants received HA alone and were allocated to a control group. Patients in both groups were treated for a total of 8 weeks. The primary outcome was measured by visual analog scale (VAS). The secondary outcomes were measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee injury and osteoarthritis outcome score (KOOS). In addition, adverse events (AEs) were also evaluated. All outcomes were measured before and after the treatment.After the treatment, patients in the treatment group exhibited better efficacy in VAS (P < .01), WOMAC scale (pain, P < .01; function, P < .01; and stiffness, P < .01), and KOOS scores (pain, P < .01; function in daily living, P < .01; symptoms, P < .01; sport and recreation, P < .01; and quality of life, P < .01), than patients in the control group. In addition, no significant differences regarding the AEs were found between 2 groups.The findings of this study demonstrated that the efficacy of EPSW combined with HA is superior to the HA alone for patients with KOA.

Mechanical Stimulation (Pulsed Electromagnetic Fields "PEMF" and Extracorporeal Shock Wave Therapy "ESWT") and Tendon Regeneration: A Possible Alternative.

The pathogenesis of tendon degeneration and tendinopathy is still partially unclear. However, an active role of metalloproteinases (MMP), growth factors, such as vascular endothelial growth factor (VEGF) and a crucial role of inflammatory elements and cytokines was demonstrated. Mechanical stimulation may play a role in regulation of inflammation. In vitro studies demonstrated that both pulsed electromagnetic fields (PEMF) and extracorporeal shock wave therapy (ESWT) increased the expression of pro-inflammatory cytokine such as interleukin (IL-6 and IL-10). Moreover, ESWT increases the expression of growth factors, such as transforming growth factor β(TGF-β), (VEGF), and insulin-like growth factor 1 (IGF1), as well as the synthesis of collagen I fibers. These pre-clinical results, in association with several clinical studies, suggest a potential effectiveness of ESWT for tendinopathy treatment. Recently PEMF gained popularity as adjuvant for fracture healing and bone regeneration. Similarly to ESWT, the mechanical stimulation obtained using PEMFs may play a role for treatment of tendinopathy and for tendon regeneration, increasing in vitro TGF-β production, as well as scleraxis and collagen I gene expression. In this manuscript the rational of mechanical stimulations and the clinical studies on the efficacy of extracorporeal shock wave (ESW) and PEMF will be discussed. However, no clear evidence of a clinical value of ESW and PEMF has been found in literature with regards to the treatment of tendinopathy in human, so further clinical trials are needed to confirm the promising hypotheses concerning the effectiveness of ESWT and PEMF mechanical stimulation.

Extracorporeal shock wave therapy for treatment of heel pain

To explore the therapeutic efficacy of extracorporeal shock wave (ESW) for persistent heel pain. A total of 98 patients of persistent heel pain were randomly divided into ESW treatment and control groups (n=49 each). Treatment group had ESW while control group received infrared physical therapy. And their visual analogue scale (VAS) scores were assessed. After one course of treatment, VAS heel pain and function scores were (39.6±6.2) and (25.1±4.6) in ESW group versus (32.3±6.5) and (17.4±7.2) in control group. And before treatment, (16.5±4.6) and (14.4±8.6), (16.1±4.7) and (14.6±8.4) respectively. Heel pain significantly decreased with functional improvement (all P<0.05). After one course, the effective rate was 65% (32/49) in treatment group. And the improvement rate of 31% (15/49) was better than control group [27% (13/49) and 63% (31/49)] (all P<0.05). ESW treatment of persistent heel pain was more efficacious than physical therapy and it could be applied clinically. Key words: Shock waves; Heel spur

Comparison of Intravenous Sedation Versus General Anesthesia on the Efficacy of the Doli 50 Lithotriptor

We compared the impact of intravenous sedation versus general anesthesia on the efficacy of extracorporeal shock wave lithotripsy. From November 1997 to May 1998, 295 patients with a single renal or upper ureteral radioopaque stone of less than 2 cm. were treated with the Doli 50 lithotriptor (Dornier Medical Systems, Marietta, Georgia). The treating anesthesiologist and patient together elected intravenous sedation or general anesthesia. Of the 92 patients 60 (65%) treated under intravenous sedation and 126 of the 203 (62%) treated under general anesthesia had 3-month followup records available for review. Extracorporeal shockwave lithotripsy was considered a failure if residual stone fragments remained after 3 months, or an auxiliary procedure or re-treatment was required. At 3 months the stone-free rate in patients treated under intravenous sedation was 55% compared with 87% in those treated under general anesthesia (p <0.001). There was no statistically significant difference in treatment time or the power index in the 2 groups. Stone size (1 to 10 versus 11 to 20 mm.) did not significantly affect the anesthesia specific stone-free rate. For single renal or upper ureteral stones less than 2 cm. a significantly better 3-month stone-free rate is achieved with the Doli 50 lithotriptor when general anesthesia is used instead of intravenous sedation.