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Shockwave Therapy and Anesthesia: What Evidence is there?

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 13-15 | Paulo Roberto Dias Santos, Bruno Schiefer Dos Santos, Nacime Salomao Barbachan Mansur DOI: 10.13107/jrs.2021.v01.i01.009

Author: Paulo Roberto Dias Santos [1], Bruno Schiefer Dos Santos [1], Nacime Salomao Barbachan Mansur [1,2]

[1] Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

[2] Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa.

 

Address of Correspondence:
Dr. Nacime Salomao Barbachan Mansur, MD, PhD.
Departamento de Ortopedia e Traumatologia, Disciplina de Ortopedia e Traumatologia, Escola Paulista de Medicina – Universidade Federal de São Paulo, Brazil.
E-mail: nacime@uol.com.br

Abstract

Introduction: The use of anesthetics on extracorporeal shockwave therapy (ESWT) for musculoskeletal disorders is a matter of debate. Although widely performed, especially on focal procedures, its scientific background is sparse. This study aims to review the current evidence
on the use of anesthetics in ESWT.
Methods: A literature review of the PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases was performed. Studies assessing or comparing the use of any type of anesthetic in any form of shockwave therapy were collected.

Results: After inclusion and exclusion criteria assessment, a total of seven studies were found to directly address the subject and only four were original articles.
Conclusion: The produced evidence is small and lacks methodological quality. These facts support the necessity for new studies using the present technology to determine the real effect of anesthetics on ESWT.

Level of Evidence: Level V. Literature Review

Keywords: Shock waves, Radial pressure waves, Quality standards

Reference:

  1. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012;7:11.
  2. Moya D, Ramon S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
  3. Schmitz C, Csaszar NB, Milz S, Schieker M, Maffulli N, Rompe JD, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: A systematic review on studies listed in the PEDro database. Br Med Bull 2015;116:115-38.
  4. Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: A systematic review including quantification of patient-rated pain reduction. Br J Sports Med 2018;52:387-407..
  5. Schaden W, Thiele R, Kolpl C, Pusch M, Nissan A, Attinger CE, et al. Shock wave therapy for acute and chronic soft tissue wounds: A feasibility study. J Surg Res 2007;143:112.
  6. Barbachan Mansur NS, Matsunaga FT, Carrazzone OL, Dias dos Santos P, Schiefer Dos Santos B, Nunes CG, et al. Shockwave therapy plus eccentric exercises versus isolated eccentric exercises for achilles insertional tendinopathy: A double-blinded randomized clinical trial. J Bone Joint Surg Am 2021;103:1295-302.
  7. 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.
  8. Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop 1991;15:181-4.
  9. Treatment ISFMS. ISMST Guidelines. Italy: University of Florence; 2019.
  10. Rompe JD, Meurer A, Nafe B, Hofmann A, Gerdesmeyer L. Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis. J Orthop Res 2005;23:931-41.
  11. Labek G, Auersperg V, Ziernhöld M, Poulios N, Böhler N. Influence of local anesthesia and energy level on the clinical outcome of extracorporeal shock wave-treatment of chronic plantar fasciitis. Z Orthop Ihre Grenzgeb 2005;143:240-6.
  12. Furia JP. High-energy extracorporeal shock wave therapy as a treatment for insertional Achilles tendinopathy. Am J Sports Med 2006;34:733-40.
  13. Klonschinski T, Ament SJ, Schlereth T, Rompe JD, Birklein F. Application of local anesthesia inhibits effects of low-energy extracorporeal shock wave treatment (ESWT) on nociceptors. Pain Med 2011;12:1532-7..
  14. Ramon S, Español A, Yebra M, Morillas JM, Unzurrunzaga R, Freitag K, et al. Current evidences in shockwave treatment. SETOC (spanish society of shockwave treatment) recommendations. Rehabilitacion (Madr) 2021;55:291-300.
  15. Schultheiss R. Stoßwellen-technologie in orthop¨adie undunfallchirurgie. In: Chaussy C, Eisenberger F, Jocham D, Wilbert D, editors. Die Stoßwelle. Forschung und Klinik. Germany: Attempto, Tubingen; 1995.
  16. Lohrer H, Nauck T, Korakakis V, Malliaropoulos N. Historical ESWT paradigms are overcome: A narrative review. Biomed Res Int 2016;2016:3850461.
  17. Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. Substance P and prostaglandin E2 release after shock wave application to the rabbit femur. Clin Orthop Relat Res 2003;406:237-45.
  18. Hausdorf J, Lemmens MA, Kaplan S, Marangoz C, Milz S, Odaci E, et al. Extracorporeal shockwave application to the distal femur of rabbits diminishes the number of neurons immunoreactive for substance P in dorsal root ganglia L5. Brain Res 2008;1207:96-101.
  19. Schmitz C, DePace R. Pain relief by extracorporeal shockwave therapy: An update on the current understanding. Urol Res 2009;37:231-4.
  20. Weber M, Birklein F, Neundorfer B, Schmelz M. Facilitated neurogenic inflammation in complex regional pain syndrome. Pain 2001;91:251-7.
  21. Hsieh ST, Lin WM. Modulation of keratinocyte proliferation by skin innervation. J Invest Dermatol 1999;113:579-86.
  22. Goto T, Yamaza T, Kido MA, Tanaka T. Light-and electron-microscopic study of the distribution of axons containing substance P and the localization of neurokinin-1 receptor in bone. Cell Tissue Res 1998;293:87-93.
  23. Brain SD, Williams TJ. Substance P regulates the vasodilator activity of calcitonin gene-related peptide. Nature 1988;335:73-5.
  24. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987;30:115-26.

 

 

How to Cite this article: Santos PRD, Dos Santos BS, Mansur NSB | Shockwave therapy and anesthesia: What evidence is there? | Journal of Regenerative Science | December 2021;1(1):13-15.

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Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 9-12 | José Eid, Daniel Moya DOI: 10.13107/jrs.2021.v01.i01.007

Author: José Eid [1], Daniel Moya [2]

[1] Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.

[2] Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.

Address of Correspondence:
Dr. José Eid, MD.
Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.
E-mail: j.eid@uol.com.br

Abstract

Focused shockwaves and radial pressure waves are safe and effective if used correctly. Nevertheless, poor results and complications have been described due to missdiagnosis and technical errors. The aim of this review is to introduce the basic principles of quality and technical recommendations for each method.

Keywords: Shock waves, Radial pressure waves, Quality standards

Reference:

  1. Delius M, Brendel W. Historical roots of lithotripsy. J Lithotr Stone Dis 1990;2:161-3.
  2. 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;100:251-63.
  3. Loske AM. Medical and Biomedical Applications of Shock Waves. Cham, Switzerland: Springer International; 2017. p. 19-42.
  4. Novak P. Physics: F-SW and R-SW. Basic information on focused and radial shock wave physics. In: Lohrer H, Gerdesmeyer L, editors. Multidisciplinary Medical Applications. Heilbronn: Buchverlag; 2014. p. 28-49.
  5. Consenso de la Federación Ibero-Latinoamericana de Ondas de Choque e Ingeniería Tisular Sobre las Bases Físicas de las Ondas de Choque Focales y de las Ondas de Presión Radial. Available from: https://onlat.net/?page_id=2497 [Last accessed on 2021 June 09].
  6. Eid J. ISMST Consensus Statement Terms and Definitions. https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/Consensus_MBRadial_pressure_wave_2017_SS.pdf [Last accessed on 2021 June 09].
  7. European Commission DG Health and Consumer. Medical Devices: Guidance document. Classification of medical devices. MEDDEV 2. 4/1. Available from: https://pdf4pro.com/download/medical-devices-guidance-document-6fa97.html [Last accessed on 2021 June 09].
  8. Digest Guidelines for Extracorporeal Shockwave Therapy. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/ISMST_Guidelines.pdf [Last accessed on 2021 June 09].
  9. Kibler WB. Value on the front end: Making the effective diagnosis for optimal treatment. Arthroscopy 2017;33:493-5.
  10. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Malos resultados y complicaciones en el uso de ondas de choque focales y ondas de presión radial en patología musculoesquelética [Poor results and complications in the use of focused shockwaves and radial pressure waves in musculoskeletal pathology]. Rehabilitacion (Madr) 2021;2021:00031-1.
  11. International Society for Medical Shockwave Treatment. Consensus Statement on ESWT Indications and Contraindications. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/ISMST_consensus_statement_on_indications_and_contraindications_20161012_final.pdf [Last accessed on 2021 June 09].
  12. Wright JG. Revised grades of recommendation for summaries or reviews of orthopaedic surgical studies. J Bone Joint Surg Am 2006;88:1161-2.
  13. Ramon S, Español A, Yebra M, Morillas JM, Unzurrunzaga R, Freitag K, et al. Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations. Rehabilitacion (Madr) 2021;55(4):291-300.
  14. Wang CJ, Huang HY, Yang K, Wang FS, Wong M. Pathome-chanism of shock wave injuries on femoral artery, vein andnerve. An experimental study in dogs. Injury. 2002;33:439-46.
  15. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. JAMA. 2002;288:1364-72.
  16. Njawaya MM, Moses B, Martens D, Orchard JJ, Driscoll T, Negrine J, et al. Ultrasound guidance does not improve the results of shock wave for plantar fasciitis or calcific achilles tendinopathy: A randomized control trial. Clin J Sport Med 2018;28:21-7.
  17. Charrin JE, Noel ER. Shockwave therapy under ultrasonographic guidance in rotator cuff calcific tendinitis. Jt. Bone Spine 2001;68:241-4.
  18. Sabeti-Aschraf M, Dorotka R, Goll A, Trieb K. Extracorporeal shock wave therapy in the treatment of calcific tendinitis of the rotator cuff. Am J Sports 2005;33:1365-8.

 

How to Cite this article: Eid J, Moya D | Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders. | Journal of Regenerative Science | December 2021; 1(1): 9-12.

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Shock Waves and Radial Pressure Waves: Time to Put a Clear Nomenclature into Practice

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 4-8 | Achim M. Loske, Daniel Moya DOI: 10.13107/jrs.2021.v01.i01.005

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

[1] Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Blvd. Juriquilla 3001, Querétaro, Qro., 76230, México.

[2] Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.

Address of Correspondence:
Dr. Daniel Moya, MD
Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.
E-mail: drdanielmoya@yahoo.com.ar

Abstract

Extracorporeal focused shock wave therapy and radial pressure wave therapy are noninvasive approaches with high success rates that hold promise for treating a rapidly increasing number of clinical indications. However, reports, presentations at scientific meetings, and information published by manufacturers reflect confusion in the terminology used. This situation is worrisome because both desired and undesired biological effects depend on the pressure profile and the physical parameters used. Moreover, in many cases, the detailed biological mechanisms involved are yet not fully understood. Only a clear knowledge of the physical concepts can enable comparison among and improvement of treatment protocols and technology. Fortunately, specific definitions and recommendations have been agreed upon by scientific societies promoting international standardization. The main goal of this article is to raise awareness of the importance of having a clear nomenclature worldwide and explain some of the concepts based on the international consensus that has been accepted to date.

Keywords: Shock waves, Radial pressure waves, Physical parameters .

Reference:

  1. Britannica, the Editors of Encyclopaedia. International System of Units. Encyclopedia Britannica, 30 Jul; 2020. Available from: https://www.britannica.com/science/International-System-of-Units [Last accessed on 2021 May 8].
  2. Metric Convention of 1875. US Metric Association. Available from: https://usma.org/laws-and-bills/metric-convention-of-1875 [Last accessed on 2021 May 8].
  3. Delius M, Brendel W. Historical roots of lithotripsy. J Lithotr Stone Dis 1990;2:161-3.
  4. Chaussy C, Eisenberger F, Forssmann B. Epochs in endourology; extracorporeal shockwave lithotripsy (ESWL): A chronology. J Endourol 2007;21:1249-53.
  5. Loske AM. Medical and Biomedical Applications of Shock Waves. Cham, Switzerland: Springer International; 2017. p. 19-42.
  6. Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, et al. Guidelines on Urolithiasis. Arnhem, Netherlands: European Association of Urology; 2015. Available from: https://uroweb.org/wp-content/uploads/22-Urolithiasis_LR_full.pdf [Last accessed on 2021 May 8].
  7. Graff J, Richter KD, Pastor J. Effect of high energy shock waves on bony tissue. Urol Res 1988;16:252-8.
  8. Karpmann RR, Magee FP, Gruen TWS, Mobley T. The lithotriptor and its potential use in the revision of total hip arthroplasty. Orthop Rev 1987;16:38-42.
  9. Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop 1991;15:181-4.
  10. Rompe JD, Rumler F, Hopf C, Nafe B, Heine J. Extracorporal shock wave therapy for calcifying tendinitis of the shoulder. Clin Orthop Relat Res 1995;321:196-201.
  11. Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases. J Urol 1997;158:4-11.
  12. Lohrer H, Gerdesmeyer L, editors. Shock wave therapy in practice. In: Multidisciplinary Medical Applications. Heilbronn: Buchverlag; 2014. p. 50-69.
  13. Speed C. A systematic review of shockwave therapies in soft tissue conditions: Focusing on the evidence. Br J Sports Med 2014;48:1538-42.
  14. Mittermayr R, Antonic V, Hartinger J, Kaufmann H, Redl H, Téot L, et al. Extracorporeal shock wave therapy (ESWT) for wound healing: Technology, mechanisms, and clinical efficacy. Wound Repair Regen 2012;20:456-65..
  15. 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;100:251-63.
  16. Auersperg V. DIGEST Guidelines for Extracorporeal Shock Wave Therapy. Physics and Technology of ESWT. Available from: http://www.setoc.es/docs/DIGEST%20guidelines_June%202019_E_A.pdf [Last accessed on 2021 May 8].
  17. IEC 61846 International Standard Ultrasonics/Pressure Pulse Lithotripters/Characteristics of Fields. Vol. 18. Geneva, Switzerland: International Electrotechnical Commission; 1998.
  18. Ueberle F, Rad AJ. Ballistic pain therapy devices: Measurement of pressure pulse parameters. Biomed Tech 2012;57:700-3.
  19. International Society for Medical Shockwave Therapy: Physical principles of ESWT Basic Physical Principles. Available from: https://www.shockwavetherapy.org/about-eswt/physical-principles-of-eswt [Last accessed on 2021 May 8].
  20. Novak P. Physics: F-SW and R-SW. Shock wave therapy in practice. Basic information on focused and radial shock wave physics. In: Lohrer H, Gerdesmeyer L, editors. Multidisciplinary Medical Applications. Heilbronn: Buchverlag; 2014. p. 28-49.
  21. Federación Ibero-Latinoamericana de Ondas de Choque e Ingeniería Tisular (Onlat) Ondas de Choque en Medicina: La Nueva Frontera. Available from: https://onlat.net/?page_id=2491 [Last accessed on 2021 May 8].
  22. European Commission DG Health and Consumer. Medical Devices: Guidance Document. Classification of medical devices. MEDDEV 2. 4/1 Rev. 9 June 2010. Available from: https://pdf4pro.com/download/medical-devices-guidance-document-6fa97.html [Last accessed on 2021 May 8].
  23. Eid J. ISMST Consensus Statement Terms and Definitions. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/Consensus_MBRadial_pressure_wave_2017_SS.pdf [Last accessed on 2021 May 8].
  24. Consenso de la Federación Ibero-Latinoamericana de Ondas de Choque e Ingeniería Tisular Sobre las Bases Físicas de las Ondas de Choque Focales y de las Ondas de Presión Radial. Available from: https://onlat.net/?page_id=2497 [Last accessed on 2021 May 8].
  25. Consensus Statement on ESWT Indications and Contraindications. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/Formulare/ISMST_consensus_statement_on_indications_and_contraindications_20161012_final.pdf [Last accessed on 2021 May 8].
  26. Recommendation Statement of the Conjoint Physics Working Group of ISMST and DIGEST on ESWT study design and publication. ISMST Recommendations. Available from: https://www.shockwavetherapy.org/about-eswt/ismst-recommendations [Last accessed on 2021 May 8].
  27. Ramon S, Español A, Yebra M, Morillas JM, Unzurrunzaga R, Freitag K, et al. Ondas de choque. Evidencias y recomendaciones SETOC (Sociedad Española de Tratamientos con Ondas de Choque). Rehabilitación (Madr) 2021;55:291-300.
  28. Sociedade Médica Brasileira de Tratamento por Ondas de Choque. Physical Features. Available from: https://www.sbtoc.org.br/aspectos-fisicos [Last accessed on 2021 May 8].
  29. Deutschsprachige Internationale Gesellschaft für Extrakorporale Stoßwellentherapie: Technology, Technical Differences. Available from: https://www.digest-ev.de/gesellschaft/geschichte.html [Last accessed on 2021 May 8].

 

How to Cite this article: Loske AM, Moya D | Shock waves and radial pressure waves: time to put a clear nomenclature into practice. | Journal of Regenerative Science | December 2021; 1(1): 4-8.

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