Extracorporeal Shockwave Therapy: Difference between revisions
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== History of extracorporeal shockwave therapy == | == History of extracorporeal shockwave therapy == | ||
Clinical use of ESWT was first introduced into practice in 1982 for urologic conditions <ref>C. Chaussy, E. Schmiedt, D. Jocham, W. Brendel, B. Forssmann, V. Walther '''First clinical experience with extracorporeally induced destruction of kidney stones by shock waves''' J Urol, 127 (1982), pp. 417-420</ref>. The success of this technology for the treatment of urinary stones quickly made it a first-line, noninvasive, and effective method<ref>A.N. Argyropoulos, D.A. Tolley '''Optimizing shock wave lithotripsy in the 21st century''' Eur Urol, 52 (2007), pp. 344-352</ref>. Subsequently, ESWT was studied in orthopedics where is was identified that ESWT could loosen the cement in total hip arthroplasty revisions<ref>S.H. Park, J.B. Park, J.N. Weinstein, S. Loening '''Application of extracorporeal shock wave lithotripter (ECSWL) in orthopedics. I. Foundations and overview''' J Appl Biomater, 2 (1991), pp. 115-126</ref>. Further, animal studies conducted in the 1980s revealed that ESWT could augment the bone-cement interface and also found an osteogenic response and improved fracture healing. While benefits in fracture healing have been shown with ESWT the majority of orthopedic research has focused on upper and lower extremity tendinopathies, fasciopathies, and soft tissue conditions. | Clinical use of ESWT was first introduced into practice in 1982 for urologic conditions <ref>C. Chaussy, E. Schmiedt, D. Jocham, W. Brendel, B. Forssmann, V. Walther '''First clinical experience with extracorporeally induced destruction of kidney stones by shock waves''' J Urol, 127 (1982), pp. 417-420</ref>. The success of this technology for the treatment of urinary stones quickly made it a first-line, noninvasive, and effective method<ref>A.N. Argyropoulos, D.A. Tolley '''Optimizing shock wave lithotripsy in the 21st century''' Eur Urol, 52 (2007), pp. 344-352</ref>. Subsequently, ESWT was studied in orthopedics where is was identified that ESWT could loosen the cement in total hip arthroplasty revisions<ref>S.H. Park, J.B. Park, J.N. Weinstein, S. Loening '''Application of extracorporeal shock wave lithotripter (ECSWL) in orthopedics. I. Foundations and overview''' J Appl Biomater, 2 (1991), pp. 115-126</ref>. Further, animal studies conducted in the 1980s revealed that ESWT could augment the bone-cement interface and also found an osteogenic response and improved fracture healing <ref>J.N. Weinstein, D.M. Oster, J.B. Park, S.H. Park, S. Loening '''The effect of the extracorporeal shock wave lithotriptor on the bone-cement interface in dogs''' Clin Orthop Relat Res, 235 (1988), pp. 261-267</ref><ref>G. Haupt, A. Haupt, A. Ekkernkamp, B. Gerety, M. Chvapil '''Influence of shock waves on fracture healing''' Urology, 39 (1992), pp. 529-532</ref>. While benefits in fracture healing have been shown with ESWT the majority of orthopedic research has focused on upper and lower extremity tendinopathies, fasciopathies, and soft tissue conditions. | ||
Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis | Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis | ||
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History of extracorporeal shockwave therapy[edit | edit source]
Clinical use of ESWT was first introduced into practice in 1982 for urologic conditions [1]. The success of this technology for the treatment of urinary stones quickly made it a first-line, noninvasive, and effective method[2]. Subsequently, ESWT was studied in orthopedics where is was identified that ESWT could loosen the cement in total hip arthroplasty revisions[3]. Further, animal studies conducted in the 1980s revealed that ESWT could augment the bone-cement interface and also found an osteogenic response and improved fracture healing [4][5]. While benefits in fracture healing have been shown with ESWT the majority of orthopedic research has focused on upper and lower extremity tendinopathies, fasciopathies, and soft tissue conditions.
Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis
Physiology of ESWT[edit | edit source]
Shockwaves are sound waves that have certain physical characteristics, including nonlinearity, high peak pressure followed by low tensile amplitude, short rise time, and short duration (10 ms). These characteristics generate a positive and negative phase of shockwave. The positive phase produces direct mechanical forces, whereas the negative phase generates cavitation and gas bubbles that subsequently implode at high speeds, generating a second wave of shockwaves.
In comparison to ultrasound waves, the shockwave peak pressure is approximately 1000 times greater than the peak pressure of an ultrasound wave [16].
Clinical Guidelines[edit | edit source]
Extracorporeal shockwave therapy (ESWT) is primarily used in the treatment of common orthopedic conditions. These include patellar tendinopathy, achilles tendinopathy, medial tibial stress syndrome, plantar fasciopathy and lateral epicondylitis.
There is no standardized ESWT protocol for the treatment of musculoskeletal conditions.
Resources[edit | edit source]
add appropriate resources here, including text links or content demonstrating the intervention or technique
References[edit | edit source]
- ↑ C. Chaussy, E. Schmiedt, D. Jocham, W. Brendel, B. Forssmann, V. Walther First clinical experience with extracorporeally induced destruction of kidney stones by shock waves J Urol, 127 (1982), pp. 417-420
- ↑ A.N. Argyropoulos, D.A. Tolley Optimizing shock wave lithotripsy in the 21st century Eur Urol, 52 (2007), pp. 344-352
- ↑ S.H. Park, J.B. Park, J.N. Weinstein, S. Loening Application of extracorporeal shock wave lithotripter (ECSWL) in orthopedics. I. Foundations and overview J Appl Biomater, 2 (1991), pp. 115-126
- ↑ J.N. Weinstein, D.M. Oster, J.B. Park, S.H. Park, S. Loening The effect of the extracorporeal shock wave lithotriptor on the bone-cement interface in dogs Clin Orthop Relat Res, 235 (1988), pp. 261-267
- ↑ G. Haupt, A. Haupt, A. Ekkernkamp, B. Gerety, M. Chvapil Influence of shock waves on fracture healing Urology, 39 (1992), pp. 529-532
