Invitation to the Presentation and Analysis of Prospective Data from a Multicenter Retrospective Study

Editorial | Vol 2 | Issue 2 |  Jul – Dec 2022 | page: 01-02 | Di Giorno Alfonso

DOI: 10.13107/jrs.2022.v02.i02.049

Author: Di Giorno Alfonso [1]

[1] Scientific Director of Di Giorno Rehabilitation Medical Centers, Focused Shockwave Specialist.

Address of Correspondence
Dr. Di Giorno Alfonso, MD
Scientific Director of Di Giorno Rehabilitation Medical Centers, Focused Shockwave Specialist


“FST Focused Shockwave Therapy” is a congress created to communicate the results of one of the largest Italian studies on focused shockwave therapy, carried out with the aim of evaluating the effectiveness of the aforementioned therapy in non-unions and myotendinous pathologies affecting shoulder, elbow, and hip regions.

Studies were made available by the Di Giorno Medical Rehabilitation and Sports Medicine Centers, an Italian national benchmark for focused shock wave therapy with over 35 years of experience, and 50,000 cases treated. This project was possible with the collaboration of the Orthopedic Specialty Schools of Unimore, UniRoma1 Sapienza, UniRoma2 Tor Vergata, and the Magna Graecia University of Calabria.

The Congress will open with greetings from the from the Honorary President of the Congress Prof. Giorgio De Santis, Honorary Citizen of Cosenza and Full Professor of Plastic Surgery and Dean of the Faculty of Medicine and Surgery of UniMoRe and from the President Giorgo Gasparini, Full Professor of Orthopedics, and Traumatology and Director of the School of Specialization in Orthopedics and Traumatology of the University of Magna Graecia in Catanzaro.

The President of the Italian Society of Shock Wave Therapy (SITOD), Dr. Sergio Gigliotti, will present a report.

This will be followed by a lectio magistralis by Prof. Daniel Moya welcome guest as President of the Ibero-American Federation of Shockwaves and Tissue Engineering (Onlat) and former President of the International Society for Medical Shockwave Treatment. Dr. Moya is an orthopedic surgeon specialized in shoulder surgery with decades of experience in the field of regenerative medicine and several publications on the subject.
He will analyze the development of shock waves in Latin-American.
The event will take place in two stages. A morning session of pure scientific discussion carried out by masters of Italian orthopedics, radiology, and rehabilitation medicine, and an afternoon session focused on the study object of the Congress.
The first session will include the discussion of the main shoulder, hip, and elbow tendino-myopathies and non-unions conditions with a focus on certain fundamental aspects for understanding the use of focused shock wave therapy in their treatment.
Prof. Fabio Catani Director of the Unimore Orthopedic Clinic, world expert in hip and knee robotic surgery and Prof Giuseppe Porcellini, Director of the Unimore School of Specialties of Orthopedics and Traumatology and a prominent international figure in shoulder surgery, will take care of enunciating the classifications of the pathologies covered by the Congress.
Afterward, Prof. Gumina, Full Professor in Orthopedics and Traumatology at the Sapienza University of Rome and Director of the Complex Operative Unit in Orthopedics and Traumatology in the “Sapienza” University Department of the Polo Pontino, will deal with the biological aspects and risks.
Prof. Tarantino, Full Professor of Diseases of the Locomotor System at the University of Rome “Tor Vergata,” will address the various topics from a clinical point of view, offering ideas, and applying his experience in the search for signs and suggestive symptoms that can allow to suspect and/or make a differential diagnosis between each of these conditions.
Prof Cacchio, Associate Professor of Physical Medicine and Rehabilitation at the University of L’Aquila with proven experience in the treatment of musculotendinous pathologies with shock waves, will focus on the biomechanics and pathobiomechanics underlying the myotendinous pathologies of interest.
Prof. Elizaveta Kon, Associate Professor at Humanitas University and Humanitas Research Hospital in Milan, scientific and organizational manager for various European and national research projects, will speak about orthobiology and the role of shock waves in this regard.
The radiological aspect, crucial in characterizing and monitoring these pathologies over time, will be discussed by Prof. Monetti, radiologist with extensive experience in the sports medicine and traumatological fields, and author of over 800 publications both nationally and internationally concerning the musculoskeletal system. Professor Monetti will also clarify some aspects regarding radiological monitoring during focused shock wave application.
After the clinical-diagnostic part, the focus of the congress will move toward conservative regenerative therapy, represented by the use of focused shock waves and the topic will be presented by Dr. Maria Cristina D’Agostino former President of SIDOT. During this part of the session, there will be an opportunity to discuss and learn about the ways, in which shock waves allow the regeneration of damaged tissues and the time required to achieve it.

A discussion will then follow on the surgical approaches to the aforementioned pathologies, presented to the public by nationally and internationally renowned experts, with the moderation of Prof. Catani, an expert in biomechanics and physiology of major joints, joint prosthetics, computer-assisted surgery, and robotics in knee and hip joint prosthetics and experience in the orthopedic-regenerative field; together with their experience regarding shock wave therapy. Prof. Cattani will discuss about how orthopedic surgery is currently leaning toward the regenerative rather than the reconstructive area.
The Directors of Orthopedic Clinics and Schools of Specialization in Orthopedics and Traumatology Fabio Catani, Giorgio Gasparini, Umberto Tarantino, Giuseppe Porcellini and Stefano Gumina, with their clinical experience, will also clarify the importance of carrying out appropriate rehabilitative exercises for functional recovery, the correct execution timing and the correct way to perform this regenerative treatment to obtain the maximum benefit for the patient.
During the break, the guests will be entertained with a standing lunch offered by the Congress organization to encourage knowledge and allow dialogue between the various participants.
A workshop on focused shock waves which will have the aim of showing the use of the method according to the Italian school, describing its functioning and correct execution, highlighting the mistakes not to be made to achieve a satisfactory result, and will take place for the whole day in the Medical Center.
The afternoon will focus on the presentation of 300 clinical cases treated with shock waves with stable positive results even 12 months after the start of treatment. The discussion of these cases will be moderated by leading figures of national orthopedics and will have the aim of involving all those present in a constructive way.
The program will be completed by the experience brought by the Spanish-Latin American School, headed by Prof. Daniel Moya, which will be interesting for comparison and growth for those who use the method and for those who want to start using it in the treatment of musculoskeletal pathologies.
Dr. Raffaele Scalpone, diabetologist and President of Dela Aid, will expose about the usefulness of the method in orthopedic pathologies of the diabetic and diabesity.

Finally, the entry of four other pathological conditions will be announced within a new multicenter study with prospective collection of retrospective data in the Medical Rehabilitation and Daytime Sports Medicine Centers located in Bologna, Rome, Cosenza, Lamezia Terme, organized by the four Orthopedics Specialty Schools of UniMoRe UMG Sapienza and Tor Vergata.
The Curia of Cosenza with its auditorium, the museum, the historic cathedral with the Madonna del Pilerio patroness of Cosenza will host us on this day of discussion, on this method, between the schools overlooking the two shores of the ocean. Participants will also have the opportunity to visit the historic center of Cosenza, the 750 km between the Tyrrhenian and the Ionian with the suggestive seaside villages, the beaches, the cliffs and the seabed and the typical products such as the cedars, the citrus plantations, the citrus plantations, the Olive groves and bergamot and then the Sila, the greenhouses, and still the most beautiful kilometer in Italy, the Reggio Calabria seafront, as D’Annunzio defined it, to then go to Aspromonte passing through the Costa Viola, not forgetting Isola Capo Rizzuto, Sibari with its plain and the Albanian countries and the Pollino with its national park, the second park of Europe.

Calabria 1000 before Christ was inhabited by the Italians, now it represents well a miniature Italy, Italy has everything, history, traditions, culture, seas, mountains, plains and many other things.


Dr. Di Giorno Alfonso


How to Cite this article: Invitation to the Presentation and Analysis of Prospective Data from a Multicenter Retrospective Study.  | Journal of Regenerative Science | Jul – Dec 2022; 2(2):01-02.


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Piezoelectric Shock Wave Sources: Are they Still the Cinderella to Treat Musculoskeletal Disorders?

Technical Notes | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 03-06 | Daniel Moya, Achim M. Loske
DOI: 10.13107/jrs.2022.v02.i02.51

Author: Daniel Moya [1], Achim M. Loske [2]

[1] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina,
[2] Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México,
Blvd. Juriquilla 3001, Querétaro, México.

Address of Correspondence
Dr. Daniel Moya, MD
Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina.


There are three types of focused shock wave generators: electrohydraulic, electromagnetic and piezoelectric. Although it has been postulated that there are no differences in clinical efficacy between the three, the information available on the results of the use of piezoelectric generators to treat musculoskeletal disorders is very limited.
The objective of this publication is to demonstrate the little existing evidence on piezoelectric generators and to highlight their versatility and promising future.

Keywords: Musculoskeletal disorders, Shock waves, ESWT, Piezoelectric.


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How to Cite this article: Moya D, Loske AM |Piezoelectric Shock Wave Sources: Are they Still the Cinderella to Treat Musculoskeletal Disorders?. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 03-06.

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Medical Applications of Diamagnetism: A Narrative Review

Review Article | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 07-12 | Pietro Romeo , Obando Felipe Torres , Federica di Pardo , Thomas Graus
DOI: 10.13107/jrs.2022.v02.i02.53

Author: Pietro Romeo [1], Obando Felipe Torres [2], Federica di Pardo [1], Thomas Graus [3]

[1] Periso Academy, Lugano, Switzerland,
[2] Cell Regeneration Medical Organization-University El Bosque, Bogotá, Colombia,

[3] Periso Medical Division, Pazzallo, Switzerland.

Address of Correspondence
Dr. Pietro Romeo, MD
Periso Academy, Lugano, Switzerland.


Magnetism includes the tendency of the matter to react to an incoming Magnetic Field both in attractive and repulsive way. With regard to the latter phenomenon , Diamagnetism, the ultra-structure of the matter shows unpaired electrons with an antiparallel spin, the high polarity, and the absence of a proper magnetic moment. All this results in a repulsive effect which induces the movement of diamagnetic liquids and molecules, the water first, so realizing the so called diamagnetic effect . This effect involves both the extracellular and intracellular environment, with the possibility to move various diamagnetic molecules and the flux of ions across the cell membrane, acting on the metabolic processes of the biological matter. The full realization of this phenomenon requires a high intensity of the magnetic field together with the possibility to modulate two key parameters such the Frequency and the Amplitude of the impulse. This review analyses the real and possible applications of Diamagnetism in clinical practice.

Keywords: Diamagnetism, Repulsive Effect, High Intensity Magnetic Fields.


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How to Cite this article: Romeo P, Torres OF, Di Pardo F, Graus T |Medical Applications of Diamagnetism. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 07-12.

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Treatment of Morton’s neuroma with focused shock waves Comparison between shock waves and surgery

Clinical Study | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 13-16 | Bernard Meyer , Daniel Moya
DOI: 10.13107/jrs.2022.v02.i02.055

Author: Bernard Meyer [1], Daniel Moya [2]

[1] Orthopaedic Surgeon. Moinhos de Vento Hospital, Porto Alegre, RS, Brasil,
[2] Orthopaedic Surgeon. Hospital Británico de Buenos Aires, Argentina.

Address of Correspondence
Dr. Bernard Meyer, MD,
Orthopaedic Surgeon. Moinhos de Vento Hospital, Porto Alegre, RS, Brasil.


Various treatments have been described for Morton’s neuroma. We compare the results of shock wave treatment with surgical neurectomy in a prospective series of 32 cases randomly assigned. In the group of patients treated with focused waves (17 cases), the percentage of good results was 70.6%, while in the operated patients (15 cases) it amounted to 93.2%. Poor results were found in 29.4% in shockwave group and 6.8 % in surgical group. Focused shock waves have a high, but lower success rate than surgery in the treatment of Morton’s neuromas. Nevertheless, due to their non-invasiveness and low chance of complications, they can be considered an option prior to minimally invasive and surgical techniques.

Keywords: Morton neuroma, shockwaves, neurectomy.


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8. Klontzas ME, Koltsakis E, Kakkos GA, Karantanas AH. Ultrasound-guided treatment of Morton’s neuroma. J Ultrason. 2021 Jun 7;21(85):e134-e138. doi: 10.15557/JoU.2021.0022. Epub 2021 Jun 18. PMID: 34258038; PMCID: PMC8264811.
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How to Cite this article: Meyer B, Moya D | Treatment of Morton’s neuroma with focused shock waves Comparison between shock waves and surgery. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 13-16.

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Use of shock waves in dental medicine

Literature Review | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 17-20 | Constanza P. Pantoja González, Daniel Moya, Leonardo Guiloff, Guillermo Rodríguez, Camila Leiton Lobos, Gilberto Salazar Chamorro
DOI: 10.13107/jrs.2022.v02.i02.57

Author: Constanza P. Pantoja González [1], Daniel Moya [2], Leonardo Guiloff [3], Guillermo Rodríguez [4], Camila Leiton Lobos [5], Gilberto Salazar Chamorro [6]

[1] Dental Surgeon, Diego Portales University, Chile.
[2] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina,

[3] Surgeon, Specialist in Traumatology and Orthopedics, University of Chile, Founding Partner and Past President of ACHITOC and ONLAT, Chile,
[4] Dental Surgeon, University of Buenos Aires; Endodontics Specialist, Maimonides University, Bs As; , Specialist in Oral Implantology, Catholic University of Argentina, Buenos Aires.

[5] Dental Surgeon, Diego Portales University, Specialist in Oral Maxillofacial Implantology Andrés Bello University, Chile,
[6] Dental Surgeon, Pontifical Javierana University, Colombia. Specialist in Oral Maxillofacial Implantology, Professor at San Sebastián University, Chile.

Address of Correspondence
Dr. Constanza P. Pantoja Gonzalez, DDS,

Dental Surgeon, Diego Portales University, Chile.


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How to Cite this article: Pantoja C, Moya D, Guiloff L, Rodríguez G, Leiton Lobos C, Salazar Chamorro G | Use of Shock Waves in Dental Medicine. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 17-20.

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Extracorporeal shock wave treatment in plantar fasciitis with an associated neuropathic component. How to optimize the result?

Case Report | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 21-23 | Lauro Schledorn de Camargo , Ricardo Kobayashi
DOI: 10.13107/jrs.2022.v02.i02.59

Author: Lauro Schledorn de Camargo [1], Ricardo Kobayashi [2]

[1] Orthopedic Surgeon at LC Clinic, Jundiai-SP Brazil, Brazil,
[2] Pain Center, Department of Neurology, University of São Paulo, Brazil.

Address of Correspondence
Dr. Lauro Schledorn de Camargo, MD,
Orthopedic Surgeon at LC Clinic, Jundiai-SP Brazil, Brazil.


Introduction: Current evidence supports the use of radial pressure wave and focused extracorporeal shock wave treatment (ESWT) for the treatment of chronic plantar fasciitis that does not improve with conservative treatment. Studies show that a quarter of plantar fasciitis may have an associated neuropathic component and the literature shows that neuropathic pain causes more intense pain and greater functional disability. However, there is a lack of literature on the results of ESWT in tendinopathies associated with the neuropathic pattern.
Case report: We report a case of plantar fasciitis with central sensitization and associated neuropathic component. At first, pregabalin 75mg twice a day was used, which improved the neuropathic pattern. After that, 3 sessions were performed with piezoelectric ESWT with energy of 0.12 mJ/mm2, 2000 impulses at a frequency of 8 Hz, once a week for three weeks. The patient was followed up for 3 months and had complete improvement of symptoms without functional limitation for activities of daily living.
Conclusion: This case report serves to draw attention to the importance of evaluating and treating the neuropathic pattern associated with tendinopathies in order to optimize the therapeutic result. However, randomized clinical trials are lacking to determine the real difference in results between using ESWT in nociceptive pain or in mixed pain with an associated neuropathic component.

Keywords: Chronic pain, plantar fasciitis, mixed pain, neuropathic pain, shockwaves.


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13. Morrissey D, Cotchett M, Said J’Bari A, Prior T, Griffiths IB, Rathleff MS, Gulle H, Vicenzino B, Barton CJ. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021 Oct;55(19):1106-1118. doi: 10.1136/bjsports-2019-101970.


How to Cite this article: Camargo Lsd, Kobayashi R |Extracorporeal shock wave treatment in plantar fasciitis with an associated neuropathic component. How to optimize the result?. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 21-23.

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Photobiomodulation and Clinical Applications

Abstract  | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 24 | Josep Pous
DOI: 10.13107/jrs.2022.v02.i02.61

Author: Josep Pous [1]

[1] Medical Director, CEMATEC ( Centros de Medicina Avanzada y Tecnológica), Barcelona, Spain

Address of Correspondence
Dr. Josep Pous, (Md&PhD) Medical Director CEMATEC ( Centros de Medicina Avanzada y Tecnológica),
Barcelona, Spain Spain.


There are different denominations in the literature such as low level laser therapy (LLLT), low level light therapy (LLLT), low intensity light therapy, and high power laser, but now we must accept a scientific term “Photobiomodulation.” Membranes cells have receptors such as integrins, growth factors that cause changes in the cytoskeleton and also in the nucleus. Chromophores, such as hemoglobin and water, are photon receptors but at the level of the mitochondria the main acceptors are the cytochromes, as in photosynthesis they are the chloroplasts. The absorption of photons, eminently in cytochrome C, activates the oxidation-reduction mechanisms and the production of cellular energy as Adenosine-Triphosphate (ATP). Through mediators (AMPc, ROS, and Protein kinase) they cause changes in the nucleus, increasing cell mobility and protein synthesis, responsible for cell regeneration. The biological response to the oxidation-reduction mechanism with the release of nitric oxide and the increase in energy (ATP) is responsible for the improvement of pain and inflammation. The regenerative response to mediating cellular signals increases the organization of collagen in the vertebral discs, reduces acute inflammation (TNF alpha), improves traumatized muscle (TN kappa B), and induces osteoblast differentiation. The current musculoskeletal indications are discopathy, synovitis, arthritis, traumatized muscle, and others. Research is ongoing on the application in brain trauma, stroke, neurodegenerative diseases, anxiety, and autoimmune inflammatory processes.


How to Cite this article: Pous J | Photobiomodulation and Clinicals Applications. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 24.

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Tibial Stress Syndrome in Sport

Abstract  | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 25 | Santiago Gómez García
DOI: 10.13107/jrs.2022.v02.i02.63

Author: Santiago Gómez García [1]

[1] Orthopaedic Surgeon and Sports Medicine Physician, Unidad Médica del Instituto Nacional de la Seguridad Social.
Dirección Provincial. A Coruña, Spain.

Address of Correspondence
Dr. Santiago Gómez García, MD
Orthopaedic Surgeon and Sports Medicine Physician, A Coruña, Spain.


Medial tibial stress syndrome (MTSS), also known as shin splints or tibial periostitis, is characterized by pain in the middle and lower end of the tibia; the pain is usually elicited by practicing sports or other physical activities. It is a common cause of leg pain in athletes and militaries. Prolonged military marching and physical activity involving excess training of the lower limbs contribute to the stress reaction of the bone, as confirmed by imaging studies. This condition has been considered a precursor stage for stress fracture.
The criteria for diagnosis of MTSS were established by Yates and White.
Although the prognosis of MTSS is usually benign, it can evolve to chronicity and be disabling.
Optimal treatment for MTSS has yet to be established.
Extracorporeal shockwave treatment (ESWT) is a tool aimed at alleviating symptoms and shortening recovery time in MTSS. Three studies have shown ESWT combined with a specific exercise program to be effective for MTSS. Regarding the recovery time, one study showed that the ESWT group recovered in 59 days while the control group did so in 91 days, another study obtained results compatible with scores 1 and 2 on the Likert scale in 76%. of the patients in the ESWT versus 37% of the control group. A third study showed 82.6% excellent or good results in the ESWT group as opposed to 36.8% in the control group to the Roles and Maudsley scale. In addition, the literature has pointed out the efficacy of 1-3 ESWT sessions in this pathology.


How to Cite this article: García SG | Tibial Stress Syndrome in Sport. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 25.

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Treatment of Spasticity in Patients with Brain Damage with the Association of Focused Shock Waves and Botulinum Toxin

Abstract  | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 26 | Antonio Déniz Cáceres, Pedro Saavedra Santana, María Isabel Marrero Arencibia, Jaime Hernández Alemán ,Almudena Hernández
DOI: 10.13107/jrs.2022.v02.i02.65

Author: Antonio Déniz Cáceres [1], Pedro Saavedra Santana [2], María Isabel Marrero  Arencibia [3], Jaime Hernández Alemán [4], Almudena Hernández [4]

[1] Rehabilitation Service, Hospital Universitario de Gran Canaria Dr. Negrín, Spain.

[2] Department of Mathematics, Universidad de Las Palmas de Gran Canaria, Spain.

[3] Department of Biochemestry and Molecular Biology, Universidad de Las Palmas de Gran Canaria, Spain.

[4] Universidad de Las Palmas de Gran Canaria, Spain.

Address of Correspondence
Dr. Antonio Déniz Cáceres, MD, PhD,
Rehabilitation Service, Hospital Universitario de Gran Canaria Dr. Negrín, Spain.


Introduction: Spasticity is a common complication in patients with brain damage secondary to stroke and multiple sclerosis, generating
disability and reducing the quality of life. In cases of muscles spasticity, we usually use Botulinum toxin injections (BTI) associated with
physiotherapy. Extracorporeal shock wave therapy (ESWT) is a safe, effective, and non-invasive treatment in these patients. Both methods are highly effective but currently are applied separately. Scientific evidence of the combined use of both techniques is scarce. The aim of this study is to assess the results of the association of both treatments (ESWT and BTI). On spasticity in patients secondary to stroke or multiple sclerosis.
Materials and Methods: This is a prospective study, with 6-month follow-up, including 10 adult patients with stroke or multiple sclerosis. ESWT was added to the usual treatment with BTI weekly for 3 weeks. The patients received rehabilitation during the treatment period and during the follow-up period. For statistical analysis in each of the follow-up weeks, the markers analyzed (spasticity and gait speed) were summarized in medians, which were plotted as a weekly function and the paired data were compared with the Wilcoxon test. The data were analyzed with an statistical program version 3.6.1 (R Development Core Team, 2019).
Results and Conclusions: We observed a statistically significant improvement in spasticity that was correlated with an increase in walking speed. The effectiveness of the combined treatment was superior and lasted longer than BTI alone.
Keywords: Shockwaves, Spasticity, Brain damage, Botulinum Toxin


How to Cite this article: Deniz A, Saavedra P, Marrero I, Hernández J, Hernández A | Treatment of Spasticity in Patients with Brain Damage with the Association of Focused Shock Waves and Botulinum Toxin. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 26.

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