2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control

Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 27-31 | Fuqiang Gao , Xiangwei Ma , Wei Sun , Zirong Li , Jike Lu

DOI: 10.13107/jrs.2022.v02.i01.41

Author: Fuqiang Gao [1,2], Xiangwei Ma [3], Wei Sun [1,4], Zirong Li [1,2], Jike Lu [5]

[1] Shockwave Center, Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[2] Beijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[3] Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

[4] Department of Orthopaedic Surgery, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

[5] Department of Orthopedics, Beijing United Family Hospital, Chaoyang, Beijing, China.

Address of Correspondence
Dr. Wei Sun, Shockwave Centers,
Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
E-mail: sun887@163.com


Abstract

Novel coronavirus pneumonia (corona virus disease 2019, [COVID-19]) is a novel respiratory infectious disease that has rapidly spread in many countries or regions around the world [1, 2, 3] . With the approval of the State Council, COVID-19 was included in the category B infectious diseases under the Law of the People’s People’s Republic of China on the Prevention and Control of Infectious Diseases, and the preventive and control measures for category A infectious diseases were adopted. Given the severity of the COVID-19 epidemic, the wide spread of transmission, and the human-to-human transmission, some patients with musculoskeletal disorders visiting hospitals and health care
workers engaged in medical shockwave technology are at potential risk of COVID-19 infection. The 2022 Chinese expert consensus statement on the Management of Musculoskeletal Disease Extracorporeal Shock Wave during the Prevention and Control of Novel Coronavirus Epidemic is formulated..

Keywords: Chinese expert consensus, Extracorporeal shockwave, Management, Musculoskeletal disorders, Novel coronavirus pandemic.


References:

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22. Chinese Medical Association Physical Medicine and Rehabilitation Branch, Expert Consensus Group on Extracorporeal Shockwave Therapy for Musculoskeletal Diseases. Expert Consensus on Extracorporeal Shockwave Therapy for Musculoskeletal Diseases. Chin J Phys Med Rehabil 2019;41:481-7.

 


How to Cite this article: Gao F, Ma X, Sun W, Li Z, Lu J | 2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 27-31.

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Shock Waves in Scaphoid Pseudarthrosis: A Case Series

Technical | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 39-42 | Paul German Terán1, Fidel Ernesto Cayon1, Estefania Anabel Lozada1, Alvaro Santiago Le Mari2

DOI: 10.13107/jrs.2022.v02.i01.47

Author: Paul German Terán [1], Fidel Ernesto Cayon [1], Estefania Anabel Lozada [1], Alvaro Santiago Le Marie [2]

[1] Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador.

[2] Department of General and Laparoscopic Surgery, Universidad Internacional del Ecuador, Quito, Ecuador.

Address of Correspondence
Dr. Paul German Terán,
Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador.
E-mail: paulteranmd@gmail.com


Abstract

Scaphoid fracture accounts for 60% of carpal fractures. The mechanism of fracture occurs after a fall with the hand extended, in pronation and radial or ulnar deviation in addition to the importance, they gain for their frequency; clinically, their problem lies in the high possibility of non-consolidation, due to the type of vascularization that it has, fractures located mainly in the waist and in the proximal pole are a high-risk factor. Most of the up-to-date papers available confirm a positive outcome of the use of focused extracorporeal shock wave therapy (ESWT-F) in pseudarthrosis. According to the literature, the success rate is between 50% and 91%. Complications when ESWT-F are performed by qualified personnel and following the standards established by international scientific organizations, are limited to petechiae and local hematomas having as a requirement, to be performed by trained personnel. This manuscript will discuss a series of cases treated in a certified center for the application of Focal Shock Waves between 2018 and 2021 to patients with scaphoid fracture with a diagnosis of Fracture Consolidation Delay and pseudarthrosis of scaphoids, which subjected to treatment with high-intensity focal shock waves under ultrasound guidance. We analyzed six male patients with an average age of 31.3 years who were treated with ESWT-F. About 33.3% were taken to osteosynthesis as initial management without achieving satisfactory bone consolidation; hence, ESWT-F was performed. About 0% complications were reported, bone consolidation occurred in 100% of patients on average of 6 weeks from the last session of ESWT-F. The results were clinically evaluated, where 100% of patients manifested a decrease in pain by an average of 75% at 2 weeks of the last session of ESWT-F and 100% at 12 weeks. In the imaging evaluation, the six patients (100%) showed signs of bone consolidation in the complete radiological assessment at 12 weeks and the Disabilities of the Arm, Shoulder, and Hand scale applied revealed improvement in their functional capacity.

Keywords: Scaphoid non-union, Delayed union, Extracorporeal shockwave therapy, Extracorporeal shock wave therapy, Pseudarthrosis, Disabilities of the arm, shoulder and hand


References:

1. Reigstad O, Thorkildsen R, Grimsgaard C, Melhuus K, Rokkum M. Examination and treatment of scaphoid fractures and pseudarthrosis. Tidsskr Nor Laegeforen 2015;135:1138-42.
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12. Fallnhauser T, Wilhelm P, Priol A, Windhofer C. High-energy extracorporeal shock wave therapy in delayed healing of scaphoid fractures and non-unions: Aretrospective analysis of the consolidation rate and factors relevant to therapy decisions. Handchir Microchir Plast Chir 2019;51:164-70.
13. Terán Vela P, Abarca WI, Martínez Asnalema D. Extracorporeal shock waves as a non-surgical treatment of delay of consolidation and non-bone union in diaphyseal fracture of the humerus associated with axonotmesis of the radial nerve, clinical case and literature review. Rev Ecu Med EUGENIO ESPEJO 2019;5:52-66.
14. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Poor results and complications in the use of focal shock waves and radial pressure waves in musculoskeletal pathology. Rehabilitation 2021;4:13-18.
15. D’Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015;24:147-53.
16. Wang CJ, Cheng JH, Huang CC, Yip HK, Russo S. Extracorporeal shockwave therapy for avascular necrosis of femoral head. Int J Surg 2015;24:184-7.
17. Cheng JH, Wang CJ. Biological mechanism of shockwave in bone. Int J Surg 2015;24:143-6.
18. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012;7:11.
19. Balius R, Jimenez F. Interventional Ultrasound in Sports Traumatology. I. Madrid; 2015. p. 2-4.

 


How to Cite this article: Teran PG, Cayon FE, Lozada EA, Le Marie AS | Shock Waves in Scaphoid Pseudarthrosis: A Case Series. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 39-42.

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Treatment of a Femoral Shaft Non-union in a Pediatric Patient with Focused Shock Waves

Case Report | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 36-38 | Sebastián Senes1, Gerardo Staudacher2,  Santiago Iglesias1, Daniel Moya1, Rodolfo Goyeneche2

DOI: 10.13107/jrs.2022.v02.i01.45

Author: Sebastián Senes [1], Gerardo Staudacher [2],  Santiago Iglesias [1], Daniel Moya[1], Rodolfo Goyeneche [2]

[1] Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Argentina.

[2] Servicio de Ortopedia y Traumatología Infantil, Hospital de Pediatría Garrahan, Buenos Aires, Argentina.

Address of Correspondence
Dr. Daniel Moya, MD,
Hospital Británico de Buenos Aires, Perdriel 74, C1280 AEB, CABA, Argentina.
E-mail: drdanielmoya@yahoo.com.ar


Abstract

Non-unions of the femur in children are not frequent, but when they do occur they can be very difficult to manage. Shock wave therapy has emerged as an effective option for well-chosen pseudoarthrosis cases, however there are no reports of pediatric cases. We report a 12-year-old male patient with a history of pathological fracture due to mid-diaphyseal osteomyelitis of the right femur at 8 years of age. After several surgical procedures the integrity of the femur was restored but an area of non-unions persisted at mid-diaphyseal level. He was treated with 3 sessions of focused shock waves with an electrohydraulic generator. He presented a rapid consolidation, avoiding a new endomedullary nailing surgery with bone graft.

Focused shock waves may be a useful therapeutic option in children with nonunions in well-selected cases.

Keywords: Pediatric, Fracture non-unions, Shock Waves


References:

1. Lewallen RP, Peterson HA. Nonunion of long bone fractures in children: a review of 30 cases. J Pediatr Orthop. 1985 Mar-Apr;5(2):135-42. PMID: 3988913.

2. Rockwood, Charles A., Kaye E. Wilkins, James H. Beaty, and James R. Kasser. Rockwood and Wilkins’ Fractures in Children. Philadelphia: Lippincott Williams & Wilkins, 2001

3. Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop. 1991;15(3):181-4. doi: 10.1007/BF00192289. PMID: 1743828.
4. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders. J Bone Joint Surg Am. 2018 Feb 7;100(3):251-263. doi: 10.2106/JBJS.17.00661. PMID: 29406349.
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11. Kuo SJ, Su IC, Wang CJ, Ko JY. Extracorporeal shockwave therapy (ESWT) in the treatment of atrophic non-unions of femoral shaft fractures. Int J Surg. 2015 Dec;24(Pt B):131-4. doi: 10.1016/j.ijsu.2015.06.075. Epub 2015 Jul 9. PMID: 26166737.
12. Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, Flamini S, Spacca G, Santilli V. Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J Bone Joint Surg Am. 2009 Nov;91(11):2589-97. doi: 10.2106/JBJS.H.00841. Erratum in: J Bone Joint Surg Am. 2010 May;92(5):1241. PMID: 19884432.
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15. W. Schaden, M. Pusch, C. Schwab, R. Mittermayr, H. Kuderna. Grundlagen der extrakorporalen Stoßwellentherapie (ESWT) bei Pseudarthrosen. Quality for the treated and practitioners. 47th Annual Meeting, Salzburg, Austria, 2011.
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How to Cite this article: Senes S, Staudacher G, Iglesias S, Moya D, Goyeneche R | Treatment of a femoral shaft non-union in a pediatric patient with focused shock waves | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 36-38.

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Novel Extracorporeal Magnetotransduction Therapy with Magnetolith® and Focused Electromagnetic Extracorporeal Shockwave Therapy in Medial Meniscal Tear – A Case Report

Case Report | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 32-35 | Karsten Knobloch

DOI: 10.13107/jrs.2022.v02.i01.43

Author: Karsten Knobloch [1]

[1] Sport Praxis Prof. Knobloch, Hannover, Germany.

Address of Correspondence
Prof. Dr. Karsten Knobloch,
Heiligerstr. 3, Hannover – 30159, Germany.
E-mail: professor.knobloch@sportpraxis-knobloch.de


Abstract

The case report describes a non-invasive combination of novel extracorporeal magnetotransduction therapy (EMTT) with focused extracorporeal shockwave therapy for symptomatic medial meniscal tear in a 41-year-old gentleman. Ultra-high-frequency 33 MHz ultrasound revealed a complex medial meniscal tear with a ganglion confirmed by subsequent magnetic resonance imaging. Non-invasive treatment with combined novel Magnetolith® EMTT with focused electromagnetic extracorporeal shockwave therapy for three sessions on a weekly interval. Shear wave elastography at 6 months demonstrated comparable stiffness of the healed and the healthy contralateral meniscus. The healing of the meniscal tear could be depicted by multiparametric ultra-high-frequency ultrasound (33 MHz) with novel stress testing and shear wave elastography.

Keywords: Magnetic field, Extracorporeal shockwave therapy, Extracorporeal shockwave therapy, Meniscal, Ultrasound, Pain


References:

1. Avendaño-Coy J, Comino-Suárez N, Grande-Muñoz J, Avendaño-López C, Gómez-Soriano J. Extracorporeal shockwave therapy improves pain and function in subjects with knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Int J Surg 2020;82:64-75.
2. Bedewi MA, Elsifey AA, Saleh AK, Alfaifi T. Shear wave elastography of the knee menisci. J Int Med Res 2020;48:300060520976048.
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5. d’Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015;24:147-53.
6. Gollmann-Tepeköylü C, Pölzl L, Graber M, Hirsch J, Nägele F, Lobenwein D, et al. miR-19a-3p containing exosomes improve function of ischaemic myocardium upon shock wave therapy. Cardiovasc Res 2020;116:1226-36.
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9. Knobloch K. Novel extracorporeal magnetotransduction therapy with Magnetolith and high-energy focused electromagnetic extracorporeal shockwave therapy as bone stimulation therapy for scaphoid nonunion – A case report. Med Case Rep Study Protoc 2020;2:1.
10. Knobloch K. Extracorporeal magnetotransduction therapy (EMTT) and high-energetic focused extracorporeal shockwave therapy (ESWT) as bone stimulation therapy for metacarpal non-union – A case report. Handchir Mikrochir Plast Chir 2021;53:82-6.
11. Knobloch K. Bone stimulation 4.0 – Combination of EMTT & EMTT in humerus nonunion. Unfallchirurg 2022;125:323-6.
12. Klüter T, Krath A, Stukenberg M, Gollwitzer H, Harrasser N, Knobloch K, et al. Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial. Electromagn Biol Med 2018;37:175-83.
13. Kopf S, Beaufils P, Hirschmann MT, Rotigliano N, Ollivier M, Pereira H, et al. Management of traumatic meniscus tears: The 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 2020;28:1177-94.
14. Krath A, Klüter T, Stukenberg M, Zielhardt P, Gollwitzer H, Harrasser N, et al. Electromagnetic transduction therapy in non-specific low back pain: A prospective randomised controlled trial. J Orthop 2017;14:410-5.
15. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: Osteoarthritis. Am J Sports Med 2007;35:1756-69.
16. Moretti B, Notarnicola A, Garofalo R, Moretti L, Patella S, Marlinghaus E, et al. Shock waves in the treatment of stress fractures. Ultrasound Med Biol 2009;35:1042-9.
17. Ouyang J, Zhang B, Kuang L, Yang P, Du X, Qi H, et al. Pulsed electromagnetic field inhibits synovitis via enhancing the efferocytosis of macrophages. Biomed Res Int 2020;2020:4307385.
18. Pölzl L, Nägele F, Hirsch J, Graber M, Grimm M, Gollmann-Tepeköylü C, et al. Exosome isolation after in vitro shock wave therapy. J Vis Exp 2020;(163). doi: 10.3791/61508.
19. Riley DS, Barber MS, Kienle GS, Aronson JK, von Schoen-Angerer T, Tugwell P, et al. CARE guidelines for case reports: Explanation and elaboration document. J Clin Epidemiol 2017;89:218-35.
20. Schaden W, Mittermayr R, Haffner N, Smolen D, Gerdesmeyer L, Wang CJ. Extracorporeal shockwave therapy (ESWT) – First choice treatment of fracture non-unions? Int J Surg 2015;24:179-83.
21. Kim SH, Lee HJ, Jang YH, Chun KJ, Park YB. Diagnostic accuracy of magnetic resonance imaging in the detection of type and location of meniscus tears: Comparison with arthroscopic findings. J Clin Med 2021;10:606.
22. Tang X, Coughlin D, Ballatori A, Berg-Johansen B, Waldorff EI, Zhang N, et al. Pulsed electromagnetic fields reduce interleukin-6 expression in intervertebral disc cells via nuclear factor-κβ and mitogen-activated protein kinase p38 pathways. Spine (Phila Pa 1976) 2019;44:E1290-7.
23. Wesdorp MA, Eijgenraam SM, Meuffels DE, Bierma-Zeinstra SM, Kleinrensink GJ, Bastiaansen-Jenniskens YM, et al. Traumatic meniscal tears are associated with meniscal degeneration. Am J Sports Med 2020;48:2345-52.
24. Willems A, van der Jagt OP, Meuffels DE. Extracorporeal shock wave treatment for delayed union and nonunion fractures: Asystematic review. J Orthop Trauma 2019;33:97-103.
25. Zhao Z, Wang Y, Wang Q, Liang J, Hu W, Zhao S, et al. Radial extracorporeal shockwave promotes subchondral bone stem/progenitor cell self-renewal by activating YAP/TAZ and facilitates cartilage repair in vivo. Stem Cell Res Ther 2021;12:19.

 


How to Cite this article: Knobloch K | Novel Extracorporeal Magnetotransduction Therapy with Magnetolith® and Focused Electromagnetic Extracorporeal Shockwave Therapy in Medial Meniscal Tear – A Case Report | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 32-35.

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Extracorporeal Shockwave Treatment for Managing Biofilm-mediated Infections in Dentistry: Current Knowledge and Future Perspectives

Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 22-26 | Antonia Olivares, Christina M A P Schuh, Sebastian Aguayo

DOI: 10.13107/jrs.2022.v02.i01.39

Author: Antonia Olivares [1], Christina M A P Schuh [2], Sebastian Aguayo [1,3]

[1] School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

[2] Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.

[3] Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.

Address of Correspondence
Dr. Sebastian Aguayo,
School of Dentistry and Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
E-mail: sebastian.aguayo@uc.cl


Abstract

At present, chronic non-communicable diseases are becoming more prevalent across the world. Among these pathologies, oral diseases such as dental caries and periodontitis are some of the most frequently observed in populations worldwide. These biofilm-mediated infections are produced as a consequence of a series of factors that modify the oral microenvironment and lead to dysbiosis among residing biofilms, which are particularly difficult to treat with pharmacological approaches due to their structural and anatomical characteristics. Furthermore, the recent sharp increase in antimicrobial resistance has potentiated the need for the development of novel techniques to effectively treat biofilm-mediated diseases in the mouth. One option that has recently shown promising results in vitro is the use of focused high-energy extracorporeal shockwave therapy (fhESWT) for the control of microbial growth and biofilm formation. Several studies have shown the effect of fhESWT on the treatment of biofilm-mediated infections associated with bone fractures and orthopedic implant infection, although the mechanisms behind this effect are still unknown. Regarding the oral cavity, there remains a lack of clinical studies but there are some limited in vitro and in vivo investigations that shed light on the potential of fhESWT for biofilm control. Therefore, the objective of this review is to discuss the most relevant available literature regarding the in vitro and in vivo effects of fhESWT over biofilm control, as well as the potential use of fhESWT for the treatment of oral biofilm-mediated diseases in the future.

Keywords: Bacteria, Biofilms, Extracorporeal shockwave therapy, Focused high-energy extracorporeal shockwave therapy, Fungi, Microorganisms.


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How to Cite this article: Olivares A, Schuh CMAP, Aguayo S | Extracorporeal Shockwave Treatment for Managing Biofilm-mediated Infections in Dentistry: The Current Knowledge and Future Perspectives | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 22-26.

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State of the Art in Ultrasound-Guided Surgery: Concept, Planning, Instruments, Classifications, Indications, and Literature Review

Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 16-21 | Bernáldez Domínguez Pedro, Dallo Lazzarini Ignacio
DOI: 10.13107/jrs.2022.v02.i01.37

Author: Bernáldez Domínguez Pedro [1], Dallo Lazzarini Ignacio [1]

[1] Department of Orthopaedic Surgery and Sports Medicine, SportMe Medical Center, Unit of Biological Therapies and Ultrasounds, Seville, Spain.

Address of Correspondence
Dr. Bernáldez Domínguez Pedro, Md. PhD,
Tabladilla, 2, 41013, Seville, Spain.
E-mail: pedrobernaldez@gmail.com


Abstract

Musculoskeletal ultrasound (MSK-U) and ultrasound-guided interventionism have had significant development and use in clinical practice in recent decades, including minimally invasive surgical procedures assisted by ultrasound. In the current literature, there is no consensus on the terminology of these procedures, with several terms used such as ultrasound-assisted surgery, ultrasound-guided surgery (UGS) or echo-guided surgery, sonosurgery, percutaneous ultrasound-guided procedures, and ultra-minimally invasive UGS. The MSK-U allows us to diagnose musculoskeletal injuries, but it is also a handy tool to assist us when performing different therapies on the tissues. They are procedures that require a good learning curve but that, once achieved, will allow us to develop other techniques depending on the type of pathology, obtaining good clinical results and in many cases avoiding having to open the focus or expand the surgical wound, with the advantages that this supposes. Therefore, UGS allows us to locate the exact site of the injury, understand the dynamics of the pathology; it does not need to open a wide surgical field, sometimes we will not put stitches or staples, and it can be combined with arthroscopic or endoscopic procedures (Ultrasound and Arthroscopic-guided Surgery). In this article, we describe the concept of UGS, its planning, the necessary instruments, the different indications, and a current concept review on the subject.

Keywords: Ultrasound-guided surgery, ultrasound-guided interventionism, ultrasound-assisted surgery, sonosurgery, ultrasound-arthroscopic surgery.


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How to Cite this article: Pedro BD, Ignacio DL | State of the Art in Ultrasound-Guided Surgery: Concept, Planning, Instruments, Classifications, Indications, and Literature Review. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 16-21.

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Lower Extremity Stress Fractures: General Concepts and Treatment with Focal Shock Waves and Radial Pressure Waves

Literature Review | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 09-15 | Antonia Olivares, Christina M A P Schuh, Sebastian Aguayo

DOI: 10.13107/jrs.2022.v02.i01.35

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedic Surgeon, Ankle and Foot Team, MEDS Clinic, Santiago de Chile; President of ACHITOC
(Chilean Association of Tissue Engineering and Shock Waves).

Address of Correspondence
Dr. Osvaldo Valle Toledo,
Department of Orthopedic Surgeon, Ankle and Foot Team, MEDS Clinic, Santiago de Chile; President of ACHITOC
(Chilean Association of Tissue Engineering and Shock Waves).
E-mail: osvaldo.valle@meds.cl


 

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How to Cite this article: Toledo OV | Lower Extremity Stress Fractures: General Concepts and Treatment with Focal Shock Waves and Radial Pressure Waves. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 09-15.

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Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults – A Systematic Review

Systematic Review | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 03-08 | Karsten Knobloch, Henning Lohse-Busch, Andreas Gohritz, Tomas Nedelka

DOI: 10.13107/jrs.2022.v02.i01.33

Author: Karsten Knobloch [1], Henning Lohse-Busch [2], Andreas Gohritz [3], Tomas Nedelk [4,5]

[1] Department of Sports Medicine, SportPraxis Prof. Knobloch, Hannover, Germany.

[2] Zentrum für Bewegungsstörungen, Rheintalklinik Bad Krozingen, Germany.

[3] Department of Neurology, Universitätsspital Basel, Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Suisse.

[4] Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine, Prague, Czech Republic.

[5] Department of Neurology, Czech Technical University, Faculty of Biomedical Engineering, Kladno, Czech Republic.

Address of Correspondence
Prof. Dr. Karsten Knobloch,
SportPraxis Prof. Knobloch, Heiligerstr. 3, D-30159 Hannover, Germany.
E-mail: professor.knobloch@sportpraxis-knobloch.de


Abstract

Introduction: This systemic review aims to assess the modes and treatment parameters of radial and focused extracorporeal shockwave therapy (ESWT) in spasticity based on the technologies and energy levels involved.
Materials and Methods: 1086 patients from 31 randomized-controlled trials (RCT) or cohort studies are included. 300 children were studied in seven studies (3 RCTs) with two radial and four focused electromagnetic ESWT devices and 14 studies with 443 patients using focused ESWT (electrohydraulic 46 patients, electromagnetic 367 patients, and piezoelectric 30 patients).
Results: In electromagnetic focused ESWT 8 RCTs (n = 323 patients) and three cohort studies (n = 44) used either very low-energetic (0.03–0.05 mJ/mm2) with 1500–2000 shots and 4–5 Hz with 3–5 focused sessions, or low-energetic 0.07–0.12 mJ/mm2 with 1500–2000 shots with 4–5 Hz and 1–3 sessions. The 64 children in the five electromagnetic focused trials were treated with very low-energetic 0.03 mJ/mm2, 1500 shots, and three sessions. 17 studies (n = 687) were using radial technologies with 7 RCTs (n = 349) and ten cohort studies (n = 338). Among the 17 trials, four studies (1 RCT, 3 cohort studies) included 236 children treated with either very low-energetic 0.6–1 bar (two trials) or low-energetic 1.5–3 bar with 5–10 Hz. Energy-wise three radial studies were very low-energetic 0.6–1 bar and 14 studies applied low-energetic radial pressures 1.5–3 bar. Notably, the frequency was mainly 4–8 Hz in the radial studies.
Conclusion: Both, radial and focused very low- to low-energetic ESWT improve function and reduce spasticity significantly. Adverse effects were not noted with the applied very low- to low-energetic device parameters neither among children nor in adults.

Keywords: Spasticity, Extracorporeal shock wave therapy, Extracorporeal shockwave therapy, Children.


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How to Cite this article: Knobloch K, Lohse-Busch H, Gohritz A, Nedelka T | Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults–A Systematic Review. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 03-08.

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An Invitation to the 24th World Congress of the International Society for Medical Shockwave Treatment

Editorial | Vol 2 | Issue 1 |  Jan – Jun 2022 | page: 01-02 | Tomáš Nedělka1,2,3, Petra Poklopová1,3, Jakub Katolický1,3

DOI: 10.13107/jrs.2022.v02.i01.031


Author: Tomáš Nedělka [1,2,3], Petra Poklopová [1,3], Jakub Katolický [1,3]

[1] Czech Technical University Prague, Faculty of Biomedical Engineering, Prague, Czech Republic.

[2] Charles University Prague, 2nd Medical Faculty, Prague, Czech Republic.

[3] Charles University Prague, 2nd Medical Faculty, Prague, Czech Republic.

Address of Correspondence
Dr. Tomáš Nedělka, M.D., Ph.D,
Bělohorská 416/25, Prague 6, 169 00, Czech Republic.
E-mail: tnedelka@post.cz


Editorial:

The 24th World Congress of the International Society for Medical Shockwave Treatment (ISMST) is finally here! We are very excited to invite you to this wonderful event held in magical Prague, the heart of Europe between the 8th and the 10th of September 2022.

ISMST represents an inclusive communication platform, where top class speakers share their late research and news regarding clinical applications of the shockwave science. The program of this year’s 24th world congress has been uniquely structured to cover key applications of the shockwave therapy, namely, extracorporeal shockwave therapy (ESWT) and radial pressure waves (RPW) technology.

Leading specialists, world known physicians and physiotherapists will share their insights at this highly recognized educational and informative event. The first scientific session, called “New Horizons in Shockwave Medicine,” will be introduced on Friday the 9th by Prof. Johannes Holfeld.
He is the founder and head of Cardiac Regeneration Research Group (CARE) at Innsbruck Medical University, and he will present on the purpose of ESWT in Cardiac Surgery. Prof. Holfeld is also well known for development of shockwave therapy for myocardial regeneration. In addition, Prof. Karsten Knobloch will elaborate on the new horizons in shockwave medicine and discuss the “Brain lymphatic system and its implications for Transcranial Pulse Stimulation in Neurodegenerative Diseases,” which are a novel approach of ESWT use in neurodegenerative diseases and dementia. He will also discuss the topics of ESWT in football and esthetic medicine later in the day. Prof. Knobloch is a board-certified reconstructive and esthetic surgeon, hand surgeon, and general surgeon and also the current president of the German society for extracorporeal shockwave therapy (DIGEST). Another “new horizon” – namely, the dental pathologies – will be presented by Prof. Daniel Moya rom Argentina. There will be other amazing international speakers from USA, Germany, Austria, Taipei, Czech Republic, and Italy taking part of the topic with whom you may discuss your points of interest and this will be followed by a nice cup of coffee and refreshments.

The next sessions will be dedicated to “ESWT and Sports, ESWT in Neurology, ESWT in Skin and ESWT in Urology and Sexual Medicine.” The highlight of ESWT and Sports is the lecture by Prof. Heinz Lohrer who participated as the head team physician of the German Gymnastics Olympic Teams in Barcelona, Atlanta, and Sydney. Prof. Lohrer has won multiple international awards for his research and work. He will share his insights into the use of ESWT in the Olympic games. His presentation will be followed by shockwave specialists from South Korea, Germany, Columbia, Qatar, Malaysia, and UK to name a few. For those interested in Orthopedic Sport Medicine Arthroscopy and a wide range of tendon disorders, Prof. Nicola Maffulli is definitely an important speaker not to be missed.

In the second half of the day, Dr. Tomáš Nedělka, this year’s president of the International Society for Medical Shockwave Therapy congress, wil be presenting about the latest innovations in ESWT in Neurology. Prof. Reiner Mittermayr from Austria and Dr. Irwin Goldstein from USA will be leading the individual topics during the second half of the first day of the congress.

We are going to kick off day two of the ISMST with the topic of “RPW in Physiotherapy,” whereby the leading keynote speaker is also Prof. Heinz Lohrer. Other scientific sessions on the day include “Recent Development in Orthopedics and Traumatology” and “ESWT Pain Management.” Prof. Mittermayr and Prof. Gerdesmeyer will be leading the discussions on those key subjects, whereby all delegates are encouraged to participate in interesting discussions afterward. The day will be concluded by well-known Czech specialist in rehabilitation medicine Dr. Jiří Nedělka, successor of famous professor Janda, sharing more than 20 years of experience in combining Prague School of Manual Medicine and ESWT in various myofascial applications.

We have also prepared for you an instructional certification course (ICC) for medical doctors and physiotherapists, which will be held on September 8, 2022 on the congress site. This 1-day course will enhance your knowledge about the basics of technology, indications, contraindications, and practical application of ESWT and RPW. For your information, these courses are taught by high-ranking international lecturers with great knowledge and experience in ESWT. ICC for physiotherapists is focused on the use of RPW, and the course for physicians covers not only RPW but also focuses on ESWT, which is restricted to physicians use only. This course is certified after completing a final test at the end of the course.

 

Dr. Tomáš Nedělka

Dr. Petra Poklopová

Dr. Jakub Katolický

 

 

How to Cite this article: Nedělka T, Poklopová P, Katolický J. | An invitation to the 24th World Congress of the International Society for Medical Shockwave treatment.  | Journal of Regenerative Science | Jan – Jun 2022; 2(1):01-02.


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