درمان بیماریهای مزمن ارتوپدی توسط امواج سونوگرافی پر قدرت
Extracorporeal shock wave therapy is a good alternative to surgery in orthopedic fields
Conclusion
High and moderate-energy ESWT are effective for completing resorption of calcifications at mid-term follow-up (3 months and more). The safety and efficacy of ESWT, coupled with its noninvasiveness, may offer an alternative to surgery
Purpose
Extracorporeal shock wave therapy (ESWT), is considered to be the golden standard in stone therapy, has been shown to be a good alternative to invasive surgery. ESWT application has been used in orthopedics for treatment of osseous tissue and soft tissues adjacent to bone. Other applications are the treatment of enthesopathies, tendinitis and so far. It is important to point out that for letter indications pain treatment, no special post-treatment, no general/ partial anesthesia, short treatment time and reduced risk as compared to surgery may be used low to high energy ESWT, there is no a definite dose of energy ESWT to recovery these patients up to now. The primary outcome of this study is determining the percentage of complete resorption of the calcifications in patients treated with moderate to high-energy ESWT by 3 months follow up
Methods and Materials
In this Interventional Case series Study, ESWT has performed for 44 Patients with evidence-based indications in Shoulder tendinitis, Fracture healing (nonunion), plantar fasciitis, Achilles tendinopathy, Hip fracture refereed by orthopedist working in Guilan Province in North of Iran. In Extracorporeal Shock Wave Therapy (ESWT), a wave is produced by a small explosion generated underwater inside an ‘applicator’. This wave is focused through a lens and transmitted into the tissue. Chattanooga’s Intellect Focus Shockwave device electromagnetically generates an extracorporeal shock wave, which produces a high-pressure peak in a very short amount of time (<2μs).
Results
The sample comprised 44 orthopedic patients (18 male and 26 females; mean and standard deviation age, 45.2(15.5) years; range 17 – 74 years). 42 (95.5%) had complete resorption of the calcifications (95% CI, 86.2% – 99.0%) by the 3 months. The success rate in Moderate-Energy ESWT group (0.08 mJ/mm²< Energy < 0.28 mJ/mm²) was 87.5% (14 out of 16 patients) and in High Energy ESWT group (> 0.28 mJ/mm²) was 100% (28 out of 28 patients).
