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Focused Shock Waves in Delayed Union and No-union after Intramedullary Nailing in Lower Limbs

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Case Report | Vol 4 | Issue 1 |  January-June 2024 | page: 06-08 | Josep Pous

DOI: https://doi.org/10.13107/jrs.2024.v04.i01.121

 

Author: Josep Pous [1]

[1] Orthopaedic Surgeon and Medical Director of CEMATEC, Barcelona, España.

Address of Correspondence
Dr. Josep Pous,
Orthopaedic Surgeon and Medical Director of CEMATEC, Barcelona, España.
E-mail: jpous@cematec.org

Abstract

Shock waves have changed medical therapy substantially. Accounting for the epidemiology of the treated diseases, this therapeutic tool may equal or even surpass the impact of extracorporeal shock wave lithotripsy. Lower limb fractures after intramedullary nailing generally heal without problems when there are good local conditions and no associated pathologies, but sometimes if the biomechanical or biological variables are not ideal, they can lead to a delay in healing or develop a non-union. Extracorporeal shock waves therapy is a treatment option in delayed union and no-union after intramedullary nailing in lower limbs cases in which there is mechanical stability of the fracture focus, as they can allow healing without the need for new surgeries.
Keywords: Extracorporeal shockwave therapy, Shock waves, Non-union, Delayed union

References:

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8. Tamma R, Dell’Endice S, Notarnicola A, Moretti L, Patella S, Patella V, et al. Extracorporeal shock waves stimulate osteoblast activities. Ultrasound Med Biol 2009;35:2093-100.
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15. Willems A, Van der Jagt OP, Meuffels DE. Extracorporeal shock wave treatment for delayed union and nonunion fractures: A systematic review. J Orthop Trauma 2019;33:97-103.
16. Sansone V, Ravier D, Pascale V, Applefield R, Del Fabbro M, Martinelli N. Extracorporeal shockwave therapy in the treatment of nonunion in long bones: A systematic review and meta-analysis. J Clin Med 2022;11:1977.
17. Wang CJ, Chen HS, Chen CE, Yang KD. Treatment of nonunions of long bone fractures with shock waves. Clin Orthop Relat Res 2001;387:95-101.
18. Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, et al. Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J Bone Joint Surg Am 2009;91:2589-97. Erratum in: J Bone Joint Surg Am 2010;92:1241.
19. Furia JP, Juliano PJ, Wade AM, Schaden W, Mittermayr R. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. J Bone Joint Surg Am 2010;92:846-54.
20. Notarnicola A, Moretti L, Tafuri S, Gigliotti S, Russo S, Musci L, et al. Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid. Ultrasound Med Biol 2010;36:1306-13.
21. 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.
22. Haffner N, Antonic V, Smolen D, Slezak P, Schaden W, Mittermayr R, et al. Extracorporeal shockwave therapy (ESWT) ameliorates healing of tibial fracture non-union unresponsive to conventional therapy. Injury 2016;47:1506-13.
23. Sandoval C, Valenzuela A, Rojas C, Brañes M, Guiloff L. Extracorporeal shockwave therapy for atrophic and oligotrophic nonunion of tibia and femur in high energy trauma patients. Case series. Int J Surg 2017;9:36-40.

How to Cite this article: Pous J. Focused Shock Waves in Delayed Union and No-union after Intramedullary Nailing in Lower Limbs. Journal of Regenerative Science 2024;January-June;4(1):06-08

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Use of Focused Shock Waves in an Acute Talar Head Fracture

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Case Report | Vol 4 | Issue 1 |  January-June 2024 | page: 24-26 | Osvaldo Valle

DOI: https://doi.org/10.13107/jrs.2024.v04.i01.129

Author: Osvaldo Valle [1]

[1] Department of Orthopedic Surgeon Surgery, 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,
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: tovato@gmail.com

Abstract

Talar fractures are rare and can be difficult to manage. Even in the absence of complications, the treatment of this type of injury can be prolonged and uncomfortable for the patient. Focused shock waves have been shown to be effective in the treatment of delayed unions and non-unions. In this case report, we share our experience with the use of focused shock waves in an acute talus fracture in a patient with risk factors for healing.
Keywords: Talus, Talar fractures, Shock waves, Bone marrow edema

References:

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5. 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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12. Zura R, Mehta S, Della Rocca GJ, Steen RG. Biological Risk Factors for Nonunion of Bone Fracture. JBJS Rev. 2016 Jan 5;4(1):e5. doi: 10.2106/JBJS.RVW.O.00008. PMID: 27490008.
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14. Liu SH, Cerri-Droz P, Ling K, Loyst RA, Wang KE, Tsouris N, Komatsu DE, Wang ED. Chronic Steroid Use, Complications, and Readmission Following Open Reduction Internal Fixation of Distal Radius Fracture. J Hand Surg Glob Online. 2023 Aug 19;5(6):757-762. doi: 10.1016/j.jhsg.2023.07.007. PMID: 38106944; PMCID: PMC10721537.
15. Moonen L, Gorter E, Schipper I. The importance of vitamin D in treatment of fracture non-union: A case report. Nutrition. 2021 Jul-Aug;87-88:111192. doi: 10.1016/j.nut.2021.111192. Epub 2021 Feb 10. PMID: 33761443.
16. Lips P, van Schoor NM. The effect of vitamin D on bone and osteoporosis. Best Pract Res Clin Endocrinol Metab. 2011 Aug;25(4):585-91. doi: 10.1016/j.beem.2011.05.002. PMID: 21872800.
17. Wang CJ, Wang FS, Yang KD. Biological effects of extracorporeal shockwave in bone healing: a study in rabbits. Arch Orthop Trauma Surg. 2008 Aug;128(8):879-84. doi: 10.1007/s00402-008-0663-1. Epub 2008 Jun 17. PMID: 18560855.

 

How to Cite this article: Valle O. Use of focused shock waves in an acute talar head fracture. Journal of Regenerative Science 2024;January-June;4(1):24-26.

 

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20 Years of Treatment of Bone Non-Unions and Delayed Unions with Shock Waves

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??? | Vol 4 | Issue 1 |  January-June 2024 | page: 27-30| Paulo F Kertzman

DOI: https://doi.org/10.13107/jrs.2024.v04.i01.131

Author: Paulo F Kertzman [1]

[1] Departamento de Ortopedia, Santa Casa de São Paulo, São Paulo, SP, Brazil.

Address of Correspondence
Dr. Paulo F Kertzman
Departamento de Ortopedia, Santa Casa de São Paulo, São Paulo, SP, Brazil.
E-mail: paulofkertzman@uol.com.br

Abstract

The treatment of bone non-unions continues to be complex and prolonged in many cases. The advent of the use of mechanical waves has made it possible, through the phenomenon of mechanotransduction, to have a non-invasive tool with a low rate of complications.
This study analyzes the experience of the last 20 years with the use of shock waves.

Keywords: Non-union, shock waves, Delayed union, Mechanotransduction

References:

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22- Rompe JD, Rosendahl T, Schöllner C, Theis C. High-energy extracorporeal shock wave treatment of nonunions. Clin Orthop Relat Res. 2001 Jun;(387):102-11. doi: 10.1097/00003086-200106000-00014. PMID: 11400870.
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25- 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.
26- 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.
27- Kertzman P, Császár NB, Furia JP, Schmitz C. Radial extracorporeal shock wave therapy is efficient and safe in the treatment of fracture nonunions of superficial bones: A retrospective case series. J Orthop Surg Res 2017;12:164.
28- Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, et al. Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J Bone Joint Surg Am 2009;91:2589-97.
29- Furia JP, Juliano PJ, Wade AM, Schaden W, Mittermayr R. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. J Bone Joint Surg Am 2010;92:846-54.
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36- Schnurrer-Luke-Vrbanic T, Avancini-Dobrovic V, Sosa I, Cvijanovic O, Bobinac D. VEGF-A expression in soft tissues repaired by shockwave therapy: differences between modalities. J Biol Regul Homeost Agents. 2018 May-Jun;32(3):583-588. PMID: 29921384.
37- Gollwitzer H, Gloeck T, Roessner M, Langer R, Horn C, Gerdesmeyer L, et al. Radial extracorporeal shock wave therapy (rESWT) induces new bone formation in vivo: Results of an animal study in rabbits. Ultrasound Med Biol 2013;39:126-33.
38- Diaz-Rodriguez L, Garcia-Marinez O, Arroyo-Morales M, Ramos-Torrecillas J, De Luna-Bertos E, Ruiz C. Effect of radial extracorporeal shock wave therapy on proliferation, cell viability and phagocytosis of human osteoblasts (MG63). Adv Sci Lett 2012;17:325-9.
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How to Cite this article: Kertzman PF. 20 Years of Treatment of Non-Unions and Delayed Unions with Shock Waves. Journal of Regenerative Science 2024;January-June;4(1):27-30.

 

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Shock Wave Medicine: A Transformative Evolution in Modern Medicine

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Original Article | Vol 3 | Issue 2 |  July-December 2023 | page: 05-09 | Sunte Li, Xiaoyu Fan, Wei Sun

DOI: https://doi.org/10.13107/jrs.2023.v03.i02.89

Author: Sunte Li [1], Xiaoyu Fan [2], Wei Sun [3, 4]

[1] Friends Central School, Philadelphia, Pennsylvania, USA,
[2] Department of Surgery, Peking University People’s Hospital, Beijing, China,
[3] Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,
[4] Department of Orthopedics, Shockwave Center, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

Address of Correspondence
Dr. Wei Sun,
Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA/Department of Orthopedics, Shockwave Center, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
E-mail: wei.sun@pennmedicine.upenn.edu

Abstract

Since its inception as extracorporeal shock wave lithotripsy in the 1980s, the landscape of medical treatment has been revolutionized by the evolution of shock wave therapy. Over four decades, this therapy, now known as extracorporeal shock wave therapy (ESWT), has emerged as a cornerstone in modern medicine, redefining treatment paradigms across various medical disciplines. Certainly, despite the promising outcomes witnessed in various medical conditions such as musculoskeletal disorders, wound healing, urinary calculi, and erectile dysfunction,
it is crucial to acknowledge that shock wave therapy’s relatively short clinical tenure necessitates a cautious approach. While its effectiveness has been repeatedly demonstrated, establishing industry-standard protocols through large-scale, prospective randomized controlled trials remains imperative to solidify its standing in medical practice.
The integration of Artificial Intelligence technology holds significant promise for the future of shockwave medicine, enabling personalized treatment plans, real-time feedback, and improved cost-effectiveness.
Keywords: Shock waves, ESWT, Shockwave

 

References:

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7. Simplicio CL, Purita J, Murrell W, Santos GS, Dos Santos RG, Lana JF. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma 2020;11:S309-18.
8. Wigley CH, Janssen TJ, Mosahebi A. Shock wave therapy in plastic surgery: A review of the current indications. Aesthet Surg J 2023;43:370-86.
9. Kuo YR, Wang CT, Wang FS, Chiang YC, Wang CJ. Extracorporeal shock-wave therapy enhanced wound healing via increasing topical blood perfusion and tissue regeneration in a rat model of STZ-induced diabetes. Wound Repair Regen 2009;17:522-30.
10. Lee SY, Joo SY, Cho YS, Hur GY, Seo CH. Effect of extracorporeal shock wave therapy for burn scar regeneration: A prospective, randomized, double-blinded study. Burns 2021;47:821-7.
11. Yao H, Wang X, Liu H, Sun F, Tang G, Bao X et al. Systematic Review and Meta-Analysis of 16 Randomized Controlled Trials of Clinical Outcomes of Low-Intensity Extracorporeal Shock Wave Therapy in Treating Erectile Dysfunction. Am J Mens Health. 2022 Mar-Apr;16(2):15579883221087532. doi: 10.1177/15579883221087532. PMID: 35319291; PMCID: PMC8949743.
12. Dong L, Chang D, Zhang X, Li J, Yang F, Tan K, et al. Effect of low-intensity extracorporeal shock wave on the treatment of erectile dysfunction: A systematic review and meta-analysis. Am J Mens Health 2019;13:2. Published online. Open access: https://journals.sagepub.com/action/showCitFormats?doi=10.1177%2F1557988319846749&mobileUi=0
13. Wu WL, Bamodu OA, Wang YH, Hu SW, Tzou KY, Yeh CT, et al. Extracorporeal shockwave therapy (ESWT) alleviates pain, enhances erectile function and improves quality of Life in patients with chronic prostatitis/chronic pelvic pain syndrome. J Clin Med 2021;3602.
14. Radu CA, Kiefer J, Horn D, Rebel M, Koellensperger E, Gebhard MM, et al. Shock wave treatment in composite tissue allotransplantation. Eplasty 2011;11:e37.
15. Li HX, Zhang ZC, Peng J. Low-intensity extracorporeal shock wave therapy promotes recovery of sciatic nerve injury and the role of mechanical sensitive YAP/TAZ signaling pathway for nerve regeneration. Chin Med J (Engl) 2021;134:2710-20.
16. Mittermayr R, Hartinger J, Antonic V, Meinl A, Pfeifer S, Stojadinovic A, et al. Extracorporeal shock wave therapy (ESWT) minimizes ischemic tissue necrosis irrespective of application time and promotes tissue revascularization by stimulating angiogenesis. Ann Surg 2011;253:1024-32.
17. Yamaya S, Ozawa H, Kanno H, Kishimoto KN, Sekiguchi A, Tateda S, et al. Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal cord injury. J Neurosurg 2014;121:1514-25.
18. López-Marín LM, Rivera AL, Fernández F, Loske AM. Shock wave-induced permeabilization of mammalian cells. Phys Life Rev 2018;26-27:1-38.
19. Yeh KH, Sheu JJ, Lin YC, Sun CK, Chang LT, Kao YH, et al. Benefit of combined extracorporeal shock wave and bone marrow-derived endothelial progenitor cells in protection against critical limb ischemia in rats. Crit Care Med 2012;40:169-77.
20. Reichenberger MA, Heimer S, Schaefer A, Lass U, Gebhard MM, Germann G, et al. Extracorporeal shock wave treatment protects skin flaps against ischemia-reperfusion injury. Injury 2012;43:374-80.
21. Sung PH, Fu M, Chiang HJ, Huang CR, Chu CH, Lee MS, et al. Reduced effects of cardiac extracorporeal shock wave therapy on angiogenesis and myocardial function recovery in patients with end-stage coronary artery and renal diseases. Biomed J 2021;44:S201-9.
22. Oktaş B, Orhan Z, Erbil B, Değirmenci E, Ustündağ N. Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum. Eklem Hastalik Cerrahisi 2014;25:158-62.
23. Qiao HY, Xin L, Wu SL. Analgesic effect of extracorporeal shock-wave therapy for frozen shoulder: A randomized controlled trial protocol. Medicine (Baltimore) 2020;99:e21399.
24. Fiani B, Davati C, Griepp DW, Lee J, Pennington E, Moawad CM. Enhanced spinal therapy: Extracorporeal shock wave therapy for the spine. Cureus 2020;12:e11200.
25. Özkan E, Şenel E, Bereket MC, Önger ME. The effect of shock waves on mineralization and regeneration of distraction zone in osteoporotic rabbits. Ann Med 2023;55:1346-54.
26. Shi L, Gao F, Sun W, Wang B, Guo W, Cheng L, et al. Short-term effects of extracorporeal shock wave therapy on bone mineral density in postmenopausal osteoporotic patients. Osteoporos Int 2017;28:2945-53.
27. Hao L, Liu Y, Wang T, Guo HL, Wang D, Bi YW, et al. Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis. J Gastroenterol Hepatol 2019;34:466-73.
28. Klang E, Portugez S, Gross R, Lerner KR, Brenner A, Gilboa M, et al. Advantages and pitfalls in utilizing artificial intelligence for crafting medical examinations: A medical education pilot study with GPT-4. BMC Med Educ 2023;23:772.
29. Wójcik S, Rulkiewicz A, Pruszczyk P, Lisik W, Poboży M, Domienik-Karłowicz J. Beyond ChatGPT: What does GPT-4 add to healthcare? The dawn of a new era. Cardiol J 2023;30:1018-25.
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31. Palavicini G. Intelligent health: Progress and benefit of artificial intelligence in sensing-based monitoring and disease diagnosis. Sensors (Basel) 2023;23:9053.

How to Cite this article: Li S, Fan X, Sun W. | Shock Wave Medicine: A Transformative Evolution in Modern Medicine. | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 05-09.

 

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

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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.
E-mail: drdanielmoya@yahoo.com.ar

Abstract

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.

References:

1. Collins English Dictionary. Available from: https://www.collinsdictionary.com/dictionary/english/cinderella [Last accessed on 2022 Feb].
2. Loske AM. Medical and Biomedical Applications of Shock Waves. Cham, Switzerland: Springer International; 2017.
3. 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.
4. Loske AM, Moya D. Shock waves and radial pressure waves: Time to put a clear nomenclature into practice. J Regen Sci 2021;1:4-8.
5. Schmitz C, Császár NB, Milz S, Schieker M, Maffulli N, Rompe JD, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: Asystematic review on studies listed in the PEDro database. Br Med Bull 2015;116:115-38.
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8. Louwerens JK, Sierevelt IN, Kramer ET, Boonstra R, van den Bekerom MP, van Royen BJ, et al. Comparing ultrasound-guided needling combined with a subacromial corticosteroid injection vs high-energy extracorporeal Shockwave therapy for calcific tendinitis of the rotator cuff: A randomized controlled trial. Arthroscopy 2020;36:1823-33.e1.

9. Moya D, Gómez D, Serrano DV, Domínguez PB, Lazzarini ID, Gómez G. Treatment protocol for rotator cuff calcific tendinitis using a single-crystal piezoelectric focused shock wave source. J Vis Exp 2022;190:e64426.
10. Zwerver J, Hartgens F, Verhagen E, van der Worp H, van den Akker-Scheek I, Diercks RL. No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season: A randomized clinical trial. Am J Sports Med 2011;39:1191-9.
11. Thijs KM, Zwerver J, Backx FJ, Steeneken V, Rayer S, Groenenboom P, et al. Effectiveness of shockwave treatment combined with eccentric training for patellar tendinopathy: A double-blinded randomized study. Clin J Sport Med 2017;27:89-96.
12. PEDro: Physiotherapy Evidence Database. Available from: https://www.pedro.org.au [Last accessed on 2022Jan].
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Orthop Relat Res 2007;460:219-25.
14. Bannuru RR, Flavin NE, Vaysbrot E, Harvey W, McAlindon T. High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: A systematic review. Ann Intern Med 2014;160:542-9

15. Bechay J, Lawrence C, Namdari S. Calcific tendinopathy of the rotator cuff: A review of operative versus nonoperative management. Phys Sportsmed 2020;48:241-6.
16. Thiele S, Thiele R, Gerdesmeyer L. Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy. Int J Surg 2015;24:165-70.
17. Sansone V, Ravier D, Pascale V, Applefield R, Del Fabbro M, Martinelli N. Extracorporeal shockwave therapy in the treatment of nonunion in long bones: Asystematic review and meta-analysis. J Clin Med 2022;11:1977.
18. 23rd 2021 International Society for Medical Shockwave Treatment Congress. Available from: https://www.shockwavetherapy.org/fileadmin/user_upload/dokumente/PDFs/ISMST_2021_abstractbook_web.pdf [Last accessed on 2022 Feb].
19. Külkens C, Quetz JU, Lippert BM, Folz BJ, Werner JA. Ultrasound-guided piezoelectric extracorporeal shock wave lithotripsy of parotid gland calculi. J Clin Ultrasound 2001;29:389-94.
20. Duarsa GW, Tirtayasa PM, Duarsa GW, Pribadi F. The efficacy and safety of several types of ESWL lithotripters on patient with kidney stone below 2 cm: A meta-analysis and literature review. Teikyo Med J 2022;45:5613-24.

21. Rabenstein T, Radespiel-Tröger M, Höpfner L, Benninger J, Farnbacher M, Greess H, et al. Ten years’ experience with piezoelectric extracorporeal shockwave lithotripsy of gallbladder stones. Eur J Gastroenterol Hepatol 2005;17:629-39.
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24. Moya D, Rodríguez G. Focused Shockwaves in Dental Pathology-Preliminary Report. ISMST22-0038Use. p. 37. Available from: https://www.ismst2022.com/wp-content/uploads/2022/09/ISMST202-programme-and-abstract-book.pdf [Last accessed on 2022 Jan].

 

 

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

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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.
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7. Rompe JD, Rosendahl T, Schöllner C, Theis C. High-energy extracorporeal shock wave treatment of nonunions. Clin Orthop Relat Res. 2001 Jun;(387):102-11. doi: 10.1097/00003086-200106000-00014. PMID: 11400870.
8. Wang CJ, Chen HS, Chen CE, Yang KD. Treatment of nonunions of long bone fractures with shock waves. Clin Orthop Relat Res. 2001 Jun;(387):95-101. doi: 10.1097/00003086-200106000-00013. PMID: 11400901.
9. Schaden W, Fischer A, Sailler A. Extracorporeal shock wave therapy of nonunion or delayed osseous union. Clin Orthop Relat Res. 2001 Jun;(387):90-4. doi: 10.1097/00003086-200106000-00012. PMID: 11400900.
10. Elster EA, Stojadinovic A, Forsberg J, Shawen S, Andersen RC, Schaden W. Extracorporeal shock wave therapy for nonunion of the tibia. JOrthop Trauma. 2010 Mar; 24(3):133-41.doi: 10.1097/BOT.0b013e3181b26470. PMID: 20182248.
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.
13. Notarnicola A, Moretti L, Tafuri S, Gigliotti S, Russo S, Musci L, Moretti B. Extracorporeal shockwaves versus surgery in the treatment of pseudoarthrosis of the carpal scaphoid. Ultrasound Med Biol. 2010 Aug;36(8):1306-13. doi: 10.1016/j.ultrasmedbio.2010.05.004. PMID: 20691920.
14. Furia JP, Juliano PJ, Wade AM, Schaden W, Mittermayr R. Shock wave therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal-diaphyseal fractures. J Bone Joint Surg Am. 2010 Apr;92(4):846-54. doi: 10.2106/JBJS.I.00653. PMID: 20360507.
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.
16. International Society for Medical Shockwave Treatment. Indications. https://www.shockwavetherapy.org/about-eswt/indications/ Last Access, June 15th,2022.

 

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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Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Considerations

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 39-43 | Osvaldo Valle Toledo. DOI: 10.13107/jrs.2021.v01.i01.021

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.

 

Address of Correspondence
Dr. Osvaldo Valle Toledo, MD,
Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.
E-mail: osvaldovalletoledo@yahoo.es

Abstract

Plantar fasciopathy is the most common cause of heel pain. It is a primarily degenerative and mechanical overuse pathology. The plantar fascia fulfills important biomechanical functions in the foot, being its “windlass” mechanism, the most important function in this regard, allowing the foot to act as a single and efficient motor unit during gait. Its clinical and imaging diagnosis is fully defined, being Baxter’s nerve entrapment neuropathy, its most significant differential diagnosis. The elongation exercises constitute the basic treatment, being the extracorporeal shock wave therapy of significant utility, amplified in its effects by the association with the referred therapeutic exercises.

Keywords: Plantar fasciitis, shock waves, fasciopathy.

References:

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11. Finkenstaedt T, Siriwanarangsun P, Statum S, Biswas R, Anderson KE, Bae WC, et al. The calcaneal crescent in patients with and without plantar fasciitis: An ankle MRI study. AJR Am J Roentgenol 2018;211:1075-82.
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14. Tschopp M, Brunner F. Diseases and overuse injuries of the lower extremities in long distance runners. Z Rheumatol 2017;76:443-50.
15. Baur D, Schwabl C, Kremser C, Taljanovic MS, Widmann G, Sconfienza LM, et al. Shear wave elastography of the plantar fascia: Comparison between patients with plantar fasciitis and healthy control subjects. J Clin Med 2021;10:2351.
16. Schillizzi G, Alviti F, D’Ercole C, Elia D, Agostini F, Mangone M, et al. Evaluation of plantar fasciopathy shear wave elastography: A comparison between patients and healthy subjects. J Ultrasound 2021;24:417-22..
17. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
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19. 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.
20. Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res 2013;471:3645-52..

21. 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.
22. Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore) 2017;96:e6621.
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27. Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernández-de-Las-Peñas C, et al. Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis. Pain Med 2021;22:1630-41.
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31. Weil LS Jr., Roukis TS, Weil LS, Borrelli AH. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: Indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg 2002;41:166-72.
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How to Cite this article: Toledo OV | Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Consideration. | Journal of Regenerative Science | Dec 2021; 1(1): 39-43.

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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

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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

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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 .

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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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