The Efficacy of Focused Extracorporeal Shockwave Therapy for the Knee Osteoarthritis: A Clinical Trial Study

Osteoarthritis is the most common form of degenerative arthritis. To date, varieties of management approaches have been recommended for osteoarthritis, but their outcomes are not consistent. In the current study, it is aimed to assess the efficacy of focused shockwave therapy for the treatment of knee osteoarthritis.

The current randomized clinical trial was conducted on 42 patients (22 cases and 20 controls, with mean age of 58.02 ± 9.90 years) with knee osteoarthritis in 2018-2019, in Isfahan, Iran. Both groups received topical analgesic plus hot pack and celecoxib 200 mg 14d. The cases underwent shockwave therapy, whereas the controls underwent sham shockwave therapy. Pain score based on visual analog scale (VAS), Knee injury and Outcome Osteoarthritis Score (KOOS) and Roles and Maudsley scores were assessed basically and within 12 weeks.

Disease-related symptoms (as a part of KOOS questionnaire) improved following the interventions in both groups (P < 0.05) but the comparison between groups found no significant differences, whereas daily activities (P = 0.01) and knee-related quality of life (P = 0.003) only promoted among shockwave group. Comparison of two groups merely revealed the superiority of shockwave regarding the knee-related quality of life (P = 0.003) and pain based on VAS score (0.005). Other entities of KOSS and Roles and Maudsley scores were not statistically different between cases and controls (P > 0.05).

We found that focused shockwave use can appropriately rehabilitate the knee function and reduce knee osteoarthritis pain. Further studies to assess the best dose and the best location of shockwave administration are strongly recommended.