Comparison of Radial Pressure Waves and Focused Extracorporeal Shock Waves in Treatment of Osteoarthritis of the Knee

Original Article | Vol 3 | Issue 2 |  July-December 2023 | page: 62-66 | Xichun Sun, Suoli Cheng, Xianghua Xiong, Zhengcheng Wang

DOI: https://doi.org/10.13107/jrs.2023.v03.i02.109

Author: Xichun Sun [1], Suoli Cheng [1], Xianghua Xiong [2], Zhengcheng Wang [1]

[1] Department of Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China,
[2] Department of Orthopedics, People’s Hospital of Liangping District, Chongqing, China.

Address of Correspondence

Dr. Suoli Cheng,
Department of Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China.
E-mail: chengsuoli@126.com

Abstract

Objective: The aim of this study is to investigate and compare the clinical efficacy of radial pressure waves and focused external shock wave therapy for knee osteoarthritis (KOA).
Materials and Methods: From October 2020, 90 patients aged 45–65 years old with Kellgren and Lawrence classification (K-L) stage I and II of KOA were selected in our hospital or randomly assigned to 3 groups with 30 cases in each group. One group was treated with antiinflamatory medication. The other two groups received one course of treatment (once a week, 4 times in total) performed by using radial focused shock
waves respectively, and follow-up was conducted by telephone and outpatient review 3, 6, and 9 months after the treatment. Visual Analog Scale (VAS) and Western Ontario McMaster Osteoarthritis Index (WOMAC) osteoarthritis score were used before and after treatment.
Results: (1) VAS, WOMAC, and evaluation indexes of both treated groups were better than those of the control group (oral drug group); (3) The score of the radial group was significantly different from that of the focused group (P > 0.05).
Conclusion: (1) Focused and radial pressure waves (RPW) have good clinical therapeutic effect on early KOA (2) Comparison of long-term effect: focused shock waves are more significant than radial (3) Radial pressure waves area good indication in relatively young patients, short course of disease (within 1 year), and K-L stage I an II. (4) In older patients, with more than a year of symptoms and K-L stages II and III, focal waves are more effective than radial waves. (5) Patients with acute onset and night pain or accompanied by obvious effusion can first take nonsteroidal
drugs orally continuously for a week, and the treatment effect is better. During treatment, the drugs can be continued or stopped according to the specific conditions. When synovial edema and effusion of the joint decreased, the conventional parameters were used for treatment.
Keywords: Knee osteoarthritis, Extracorporeal shock wave therapy, Radial Pressure Waves

References:

1. Sharma L. Osteoarthritis of the knee. N Engl J Med 2021;384:51-9.
2. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Ann Rheum Dis 2001;60:91-7.
3. Liao D. Current status of epidemiologic investigation of osteoarthritis in China. Minim Invasive Med 2017;12:521-4.
4. Li Y, Li Z, Ren R, et al. Research progress in the treatment of osteoarthritis of the knee joint. Chin Contemp Med 2019;26:24-7.
5. Qiaoqiao M. Progress of clinical treatment of knee osteoarthritis. World Digest Latest Med Inf 2019;19:146-8.
6. Romeo P, Lavanga V, Pagani D, Sansone V. Extracorporeal shock wave therapy in musculoskeletal disorders: A review. Med Princ Pract 2014;23:7-13.
7. Wu YT, Yu HK, Chen LR, Chang CN, Chen YM, Hu GC. Extracorporeal shock waves versus botulinum toxin type a in the treatment of poststroke upper limb spasticity: A randomized noninferiority trial. Arch Phys Med Rehabil 2018;99:2143-50.
8. Auersperg V, Trieb K. Extracorporeal shock wave therapy: An update. EFORT Open Rev 2020;5:584-92.
9. Guan A. Comparison of the Efficacy of the Same dose of Discrete and Focused Extracorporeal Shock Waves in the Treatment of Osteoarthritis of the Knee. Taiwan: China Medical University; 2022.
10. Joint Surgery Group of the Chinese Orthopaedic Association. Guidelines for the diagnosis and treatment of osteoarthritis. Chin J Orthop 2018;38:705-15.
11. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage 2007;15:981-1000.
12. An S, Li J, Xie W, Yin N, Li Y, Hu Y. Extracorporeal shockwave treatment in knee osteoarthritis: Therapeutic effects and possible mechanism. Biosci Rep 2020;40:BSR20200926.
13. Zhao Z, Jing R, Shi Z, Zhao B, Ai Q, Xing G. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: A randomized controlled trial. J Surg Res 2013;185:661-6.
14. Zhong Z, Liu B, Liu G, Chen J, Li Y, Chen J, et al. A randomized controlled trial on the effects of low-dose extracorporeal shockwave therapy in patients with knee osteoarthritis. Arch Phys Med Rehabil 2019;100:1695-702.
15. Uysal A, Yildizgoren MT, Guler H, Turhanoglu AD. Effects of radial extracorporeal shock wave therapy on clinical variables and isokinetic performance in patients with knee osteoarthritis: A prospective, randomized, single-blind and controlled trial. Int Orthop 2020;44:1311-9.
16. Zhang YF, Liu Y, Chou SW, Weng H. Dose-related effects of radial extracorporeal shock wave therapy for knee osteoarthritis: A randomized controlled trial. J Rehabil Med 2021;53:jrm00144.
17. 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.
18. Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, et al. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res 2003;21:984-9.
19. Li JW, Zheng SJ, Zhang JC, Huang JJ, Liu XG. Effect of acupuncture plus different frequency shock-wave interventions on pain reactions and motor function in knee osteoarthritis patients. Zhen Ci Yan Jiu 2015;40:300-3.
20. Xu JK, Chen HJ, Li XD, Huang ZL, Xu H, Yang HL, et al. Optimal intensity shock wave promotes the adhesion and migration of rat osteoblasts via integrin β1-mediated expression of phosphorylated focal adhesion kinase. J Biol Chem 2012;287:26200-12.
21. Wang CJ, Hsu SL, Weng LH, Sun YC, Wang FS. Extracorporeal shockwave therapy shows a number of treatment related chondroprotective effect in osteoarthritis of the knee in rats. BMC Musculoskelet Disord 2013;14:44.
22. Chen PY, Cheng JH, Wu ZS, Chuang YC. New frontiers of extracorporeal shock wave medicine in urology from bench to clinical studies. Biomedicines 2022;10:675.
23. Fu M, Sun CK, Lin YC, Wang CJ, Wu CJ, Ko SF, et al. Extracorporeal shock wave therapy reverses ischemia-related left ventricular dysfunction and remodeling: molecular-cellular and functional assessment. PLoS One 2011;6:e24342.
24. Dias dos Santos PR, De Medeiros VP, Freire Martins de Moura JP, da Silveira Franciozi CE, Nader HB, Faloppa F. Effects of shock wave therapy on glycosaminoglycan expression during bone healing. Int J Surg 2015;24:120-3.
25. Ko NY, Chang CN, Cheng CH, Yu HK, Hu GC. Comparative effectiveness of focused extracorporeal versus radial extracorporeal shockwave therapy for knee osteoarthritis-randomized controlled study. Int J Environ Res Public Health 2022;19:9001.
26. Cleveland RO, Chitnis PV, McClure SR. Acoustic field of a ballistic shock wave therapy device. Ultrasound Med Biol 2007;33:1327-35.
27. Zhu Z, Zhu D, Jiang Y, Lin Y, Yang Y, Luan W. Cross-sectional study on the SF-36, the general self-efficacy, the social support, and the health promoting lifestyle of the young elderly in a community in Shanghai, China. Ann Palliat Med 2021;10:518-29.

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