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[Using extracorporeal shockwave therapy in orthopedics--a meta-analysis]
1Orthopädische Universitätsklinik, Rheinisch-Westfälischen Technischen Hochschule Aachen.
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|November 21, 1998
Summary
Extracorporeal Shockwave Therapy (ESWT) shows promise for conditions like calcifying tendinitis and painful heel, achieving results comparable to established methods. However, more high-quality research is needed to determine optimal parameters and long-term efficacy for broader orthopedic applications.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Evidence-Based Medicine
Context:
- Extracorporeal Shockwave Therapy (ESWT) is not yet a standard orthopedic treatment.
- The precise mechanisms of ESWT's analgesic effects and its impact on bony defects remain unclear.
- Current literature lacks sufficient high-quality studies to establish definitive therapeutic guidelines.
Purpose:
- To meta-analyze existing studies on ESWT for musculoskeletal conditions.
- To determine success rates and indications for ESWT based on current scientific knowledge.
- To identify optimal impulse and energy rates for ESWT applications.
Summary:
- A meta-analysis evaluated 4825 cases from 55 publications on ESWT.
- Only 33% of studies met rigorous scientific standards, with pseudarthrosis and enthesiopathies lacking robust evidence.
- ESWT demonstrated comparable results to established treatments for calcifying tendinitis and painful heel with no serious complications.
Impact:
- ESWT offers non-invasive treatment with a low complication rate, particularly justifiable for heel spurs due to high surgical complication rates.
- Further high-quality, evidence-based studies are crucial to define optimal ESWT parameters for specific indications.
- The current widespread use of ESWT in some settings lacks scientific justification without prior conservative treatment.
