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Myofascial Trigger Points: From Metabolic Failure to Recovery

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Research Article | Vol 6 | Issue 1 |  January-June 2026 | page: 22-26 | Blanca Piñeyro Garza

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.195

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 19 Apr 2026, Review Date: 28 May 2026, Accepted Date: April 2026 & Published: 30 June 2026

Author: Blanca Piñeyro Garza [1]

[1] Sportphysis Clinic, Monterrey, Mexico.
.

Address of Correspondence
Dr. Blanca Piñeyro Garza,
Sportphysis Clinic, Monterrey, Mexico.
E-mail: drabpineyro@gmail.com

Abstract

Background: Conventional treatment of myofascial pain has historically focused on symptom mitigation (pain relief), which may explain the high recurrence rates observed in clinical practice. Myofascial trigger points (MTrPs) represent a structural metabolic dysfunction characterized by a state of tissue hypoxia, localized “rigor mortis”, and fascial restriction.
Methods: This article aims to integrate the energy crisis model with molecular findings of tissue acidosis and ischemia, proposing a sequential non-invasive treatment triad consisting of radial pressure waves/focused shockwaves/radial pressure waves application (preparation/intervention/drainage).
Discussion: The chronological evolution of the MTrP concept is reviewed, from the integrated energy crisis hypothesis proposed by Travell and Simons to the molecular confirmation of Jay Shah’s “biochemical soup” and cytoskeletal blockade model. Shockwave therapy is introduced as a cellular “mechanical defibrillator” capable of restoring ATP synthesis and sarcomere homeostasis within a tensegrity-based framework. Treatment outcomes are further assessed using pressure algometry as an objective measure of functional recovery.
Conclusion: The BIOLOGICAL RESET protocol redefines the therapeutic approach, shifting from passive analgesic management toward active biological engineering, achieving clinical success through pure mechanotransduction.
Keywords: Myofascial pain syndrome, Trigger points, Shock waves, Radial pressure waves

References

1. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore, MD: Williams and Wilkins; 1999.
2. Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microdialysis method separates active and latent myofascial trigger points from normal muscle tissue. Arch Phys Med Rehabil 2005;86:1321-31.
3. Simons DG. New views of myofascial trigger points: Etiology and diagnosis. J Musculoskelet Pain 2008;16:17-23.
4. Gerwin RD, Shannon S, Hong CZ, Hubbard D, Gevirtz R. Interrater reliability in myofascial trigger point examination. Pain 1997;69:65-73.
5. Gerwin RD. A review of myofascial pain and tissue issues. J Musculoskelet Pain 2014;22:330-6.
6. Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89:16-23.
7. Zhuang HY, Long MJ, Zhang ZY, et al. Ultrastructural alterations of sarcomeres and sarcoplasmic reticulum in myofascial trigger points: The molecular mechanism of localized rigor mortis. J Ultrastruct Pathol 2019;43:145-54.
8. Ingber DE. Tensegrity I. Cell structure and hierarchical systems biology. J Cell Sci 2003;116:1157-73.
9. Ingber DE. Cellular tensegrity: Defining new rules of biological design that govern the cytoskeleton. J Cell Sci 1993;104:613-27.
10. Gleitz M, Hornig K. Trigger shock wave therapy in myofascial pain syndrome. Orthop Prax 2012;48:214-22.
11. Ramon S, Gleitz M, Cervallo L, et al. Focused vs. Radial shockwave therapy in myofascial trigger points: A randomized, controlled, biophysical comparative trial. Ultrasound Med Biol 2021;47:2540-51.
12. International Society for Musculoskeletal Shockwave Therapy (ISMST). Recommendations for the Clinical use of Focused and Radial Shockwave Therapy in Myofascial Pain Syndrome. Italy: ISMST Consensus Statement; 2023.
13. Fischer AA. Application of pressure algometry in quantification of myofascial pain and diagnosis of tender spots. Arch Phys Med Rehabil 1986;67:836-8.
14. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987;30:115-26.
15. Moya D, Ramón S, Schaden W, Wang CJ, Gleitz M. The combination of focused shockwaves and radial pressure waves in musculoskeletal disorders: A 2024 evidence- based consensus update on sequential clinical protocols. J Orthop Surg Res 2024;19:112-24.
16. Moya D. Myths, truths, doubts and confusions about shockwave therapy and its role in musculoskeletal pathology. Rev Asoc Argent Ortop Traumatol 2024;89:199-209.

 

How to Cite this article: Piñeyro B | Myofascial trigger points: From metabolic failure to recovery | Journal of Regenerative Science | Jan-Jun 2026; 6(1): 22-26.

 

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Methodological and Interpretative Limitations in a Case Report of Achilles Tendon Rupture Following Extracorporeal Radial Pressure Wave Therapy

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Bibliographic Analysis | Vol 6 | Issue 1 |  January-June 2026 | page: 3-5 | Daniel Moya, Achim Loske

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.187

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 25 Feb 2026, Review Date: 13 Mar 2026, Accepted Date: April 2026 & Published: 30 June 2026

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

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

Address of Correspondence
Daniel Moya,
Department of Orthopaedics, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.
E-mail: drdanielmoya@yahoo.com.ar

Abstract

This commentary critically examines a case report attributing Achilles tendon rupture to shock wave therapy. The manuscript presents significant conceptual and methodological flaws, particularly the conflation of extracorporeal shock wave therapy, radial pressure wave therapy, and percussive ultrasound, despite their distinct physical and biological characteristics. The proposed mechanism of cumulative microtrauma lacks supporting evidence and contradicts current mechanotransduction-based models. In addition, insufficient reporting of treatment parameters limits reproducibility. The authors fail to consider well-established risk factors for tendon rupture, relying instead on temporal association, which constitutes a post hoc fallacy. Overall, the conclusions are speculative, unsupported, and not aligned with existing literature.

Keywords: Shock waves, Radial pressure waves, Achilles tendinopathy, Achilles rupture

References

1. Argyropoulou E, Sakellariou E, Karampinas P, Rozis M, Galanis A, Kolovos I, et al. A case report of Achilles tendon distractive rupture after shock wave therapy. J Surg Case Rep 2025;2025:rjaf206.
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, Moya D. Shock waves and radial pressure waves: Time to put a clear nomenclature into practice. J Regen Sci 2021;1:4-8.
4. Loske AM, Moya D. Errors in shock wave therory can impact clinical outcomes. J Regen Sci 2024;4:35-6.
5. Lin TC, Lin CY, Chou CL, Chiu CM. Achilles tendon tear following shock wave therapy for calcific tendinopathy of the Achilles tendon: A case report. Phys Ther Sport 2012;13:189-92.
6. Stania M, Juras G, Chmielewska D, Polak A, Kucio C, Król P. Extracorporeal shock wave therapy for Achilles tendinopathy. Biomed Res Int 2019;2019:3086910.
7. Novak P, Verdaasdonk R. Radial ESWT update – New observations explain positive treatment results in sports medicine. In: Lohrer H, Nauck T, editors. Shock Wave Therapy in Practice: Shock Waves in Sports Medicine. Heilbronn: Buchverlag; 2017. p. 126-57.
8. D’Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015;24:147-53.
9. Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (ESWT) on tendon tissue. Muscles Ligaments Tendons J 2012;2:33-7.
10. Wess O, Mayer J. The interaction of shock waves with biological tissue – momentum transfer, the key for tissue stimulation and fragmentation. Int J Surg 2025;111:2810-28.
11. Nikolikj-Dimitrova ED, Gjerakaroska-Savevska C, Koevska V, Mitrevska B, Gocevska M, Manoleva M, et al. The effectiveness of radial extracorporeal shock wave therapy for chronic achilles tendinopathy: A case report with 18 months follow-up. Open Access Maced J Med Sci 2018;6:523-7.
12. Oda H, Sano K, Kunimasa Y, Komi PV, Ishikawa M. Neuromechanical modulation of the achilles tendon during bilateral hopping in patients with unilateral achilles tendon rupture, over 1 year after surgical repair. Sports Med 2017;47:1221-30.
13. Tarantino D, Palermi S, Sirico F, Corrado B. Achilles tendon rupture: Mechanisms of injury, principles of rehabilitation and return to play. J Funct Morphol Kinesiol 2020;5:95.
14. Wertz J, Galli M, Borchers JR. Achilles tendon rupture: Risk assessment for aerial and ground athletes. Sports Health 2013;5:407-9.
15. Oliva F, Piccirilli E, Berardi AC, Tarantino U, Maffulli N. Influence of thyroid hormones on tendon homeostasis. Adv Exp Med Biol 2016;920:133-8.
16. Maffulli N, Cuozzo F, Migliorini F, Oliva F. The tendon unit: Biochemical, biomechanical, hormonal influences. J Orthop Surg Res 2023;18:311.
17. Feng X, Qin DA, Zhang HX. Thyroid achilles tendinopathy. Int J Surg 2025;111:8678-80.
18. Elliott WC, Ouseph A, Abraham A, Martinez J, Grimes JS. The association of body mass index and Achilles tendon rupture: A retrospective case-control study. Foot Ankle Orthop 2025;10:24730114251327212.
19. Aicale R, Tarantino D, Maffulli N. Basic science of tendons. In: Gobbi A, Espregueira-Mendes J, Lane JG, Karahan M, editors. Bio-Orthopaedics: A New Approach. Netherlands: Springer; 2017. p. 249-3.
20. Costa ML, Shepstone L, Donell ST, Thomas TL. Shock wave therapy for chronic Achilles tendon pain: A randomized placebo-controlled trial. Clin Orthop Relat Res 2005;440:199-204.

How to Cite this article: Moya D, Loske A. Methodological and Interpretative Limitations in a Case Report of Achilles Tendon Rupture Following Extracorporeal Radial Pressure Wave Therapy.| Journal of Regenerative Science | Jan-Jun 2026; 6(1): 03-05.

 

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Pelvic Pain and the Use of Extracorporeal Shock Wave Therapy (ESWT)

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Review Article | Vol 5 | Issue 2 |  July-December 2025 | page: 39-41 | Romina Tang Candiotti

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.181

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 25 Oct 2025, Review Date: 12 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Romina Tang Candiotti [1]

[1] Pelvic floor unit. RENOVA MEDIC Medical Center, Lima, Perú.

Address of Correspondence
Armando Tonatiuh Ávila García,
Pelvic floor unit. RENOVA MEDIC Medical Center, Lima, Perú.
E-mail: romi.arw@gmail.com

Abstract

Chronic pelvic pain (CPP) is a heterogeneous condition affecting individuals of both sexes and may originate from urological, gynecological, gastroenterological, musculoskeletal, and neurological structures. Over the past three years (2023–2025), multiple clinical studies, reviews, and meta-analyses have evaluated the use of focused extracorporeal shock waves treatment (ESWT), low-intensity shock waves (Li-ESWT) and radial pressure waves (RPW), on specific CPP subtypes, particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), pelvic floor myofascial pain, and vulvodynia/vestibulodynia. Recent evidence suggests benefits in pain reduction and functional improvement in the short and medium term, with a favorable safety profile; however, methodological limitations and protocol heterogeneity persist.
Keywords: Chronic pelvic pain syndrome, Shock waves, Pelvic floor myofascial pain, Chronic prostatitis, Vulvodynia, Vestibulodynia.

References:

1. Skaudickas D, Lenčiauskas P, Skaudickas A, Undžytė G. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up. Open Med (Wars). 2023 Oct 28;18(1):20230832. doi: 10.1515/med-2023-0832. PMID: 37900960; PMCID: PMC10612526.
2. Hur KJ, Bae WJ, Ha US, Kim S, Piao J, Jeon KH, et al. Safety and efficacy of extracorporeal shockwave therapy on chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized, double-blind, placebo-controlled study. Prostate Int. 2024 Dec;12(4):195-200. doi: 10.1016/j.prnil.2024.06.003. Epub 2024 Jun 13. PMID: 39735201; PMCID: PMC11681323. Wang YR. Safety of low-intensity extracorporeal shock wave therapy — 2024. Revisión en PMC.
3. Huang N, Qin Z, Sun W, Bao K, Zha J, Zhang P, et al. Comparing the effectiveness of extracorporeal shockwave therapy and myofascial release therapy in chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials. 2023 Oct 18;24(1):675. doi: 10.1186/s13063-023-07633-1. PMID: 37853420; PMCID: PMC10583345.
4. Wang YR, Feng B, Qi WB, Gong YW, Kong XB, Cheng H, Dong ZL, Tian JQ, Wang ZP. Safety of low-intensity extracorporeal shock wave therapy in prostate disorders: in vitro and in vivo evidence. Asian J Androl. 2024 Sep 1;26(5):535-543. doi: 10.4103/aja202448. Epub 2024 Aug 6. PMID: 39107962; PMCID: PMC11449405.
5. Labetov I, Vaganova A, Kovalev G, Shkarupa D. Extracorporeal shockwave therapy in treatment of chronic prostatitis/chronic pelvic pain syndrome: Systematic review and meta-analyses. Neurourol Urodyn. 2024 Nov;43(8):1924-1937. doi: 10.1002/nau.25524. Epub 2024 Jun 7. PMID: 38847290. Hegazy M. A randomized trial on low-intensity shockwave therapy (2024) — publicación en revista científica (Nature-linked).
6. Hegazy M, Sheir KZ, Gaballah MA, Elshal AM. A randomized controlled trial evaluating low-intensity shockwave therapy for treatment of persistent storage symptoms following transurethral surgery for benign prostatic obstruction. Prostate Cancer Prostatic Dis. 2024 Jun;27(2):305-311. doi: 10.1038/s41391-024-00820-4. Epub 2024 Mar 29. PMID: 38553627; PMCID: PMC11096095.
7. Ogbeivor C, AlMubarak H, Akomolafe T, Alkahtani H, AlMugizel H, Marin I, Aldosari H, Aldhwayan N, Mohamed G, Alobthani K. The effectiveness of radial shockwave therapy on myofascial pain syndrome: a two-armed, randomized double-blind placebo-controlled trial. BMC Musculoskelet Disord. 2025 Apr 24;26(1):413. doi: 10.1186/s12891-025-08659-z. PMID: 40275291; PMCID: PMC12023603.
8. Hurt K, Svestkova O, Halaska M, Driak D, Rakovicova I, Musalek M, Krajcova A. Extracorporeal Shock Wave Therapy of Vulvodynia: A Feasibility Study. Actual Gyn. 2019;11:18-22

How to Cite this article: Candiotti RT. Pelvic Pain and the Use of Extracorporeal Shock Wave Therapy (ESWT). Journal of Regenerative Science. July-December 2025;5(2):39-41.

 

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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:

1. Jensen SS, Jensen NM, Gundtoft PH, Kold S, Zura R, Viberg B. Risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures: A systematic review and meta-analysis. EFORT Open Rev 2022;7:516-25.
2. Zura R, Mehta S, Della Rocca GJ, Steen RG. Biological risk factors for nonunion of bone fracture. JBJS Rev 2016;4:e5.
3. Sadat-Ali M, Al-Omar HK, AlTabash KW, AlOmran AK, AlDakheel DA, AlSayed HN. Genetic influence of fracture nonunion (FNU): A systematic review. Pharmgenomics Pers Med 2023;16:569-75.
4. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
5. Zura R, Xiong Z, Einhorn T, Watson JT, Ostrum RF, Prayson MJ, et al. Epidemiology of fracture nonunion in 18 human bones. JAMA Surg 2016;151:e162775.
6. Tian R, Zheng F, Zhao W, Zhang Y, Yuan J, Zhang B, et al. Prevalence and influencing factors of nonunion in patients with tibial fracture: Systematic review and meta-analysis. J Orthop Surg Res 2020;15:377.
7. Rompe JD, Rosendahl T, Schöllner C, Theis C. High-energy extracorporeal shock wave treatment of nonunions. Clin Orthop Relat Res 2001;387:102-11.
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.
9. Hofmann A, Ritz U, Rompe JD, Tresch A, Rommens PM. The effect of shock wave therapy on gene expression in human osteoblasts isolated from hypertrophic fracture non-unions. Shock Waves 2015;25:1:91-102.
10. Suhr F, Delhasse Y, Bungartz G, Schmidt A, Pfannkuche K, Bloch W. Cell biological effects of mechanical stimulations generated by focused extracorporeal shock wave applications on cultured human bone marrow stromal cells. Stem Cell Res 2013;11:951-64.
11. Wang CJ, Huang KE, Sun YC, Yang YJ, Ko JY, Weng LH, et al. VEGF modulates angiogenesis and osteogenesis in shockwave-promoted fracture healing in rabbits. J Surg Res 2011;171:114-9.
12. Li B, Wang R, Huang X, Ou Y, Jia Z, Lin S, et al. Extracorporeal shock wave therapy promotes osteogenic differentiation in a rabbit osteoporosis model. Front Endocrinol (Lausanne) 2021;12:627718.
13. Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases. J Urol 1997;158:4-11.
14. Alkhawashki HM. Shock wave therapy of fracture nonunion. Injury 2015;46:2248-52.
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:

1. Caracchini G, Pietragalla M, De Renzis A, Galluzzo M, Carbone M, Zappia M, Russo A, Greco F, Miele V. Talar fractures: radiological and CT evaluation and classification systems. Acta Biomed. 2018 Jan 19;89(1-S):151-165. doi: 10.23750/abm.v89i1-S.7019. PMID: 29350644; PMCID: PMC6179081.
2. Anderson MR, Flemister AS, Ketz JP. Operative Treatment of Talar Head Fractures: Surgical Technique. J Orthop Trauma. 2018 Aug;32(8):e334-e338. doi: 10.1097/BOT.0000000000001178. Erratum in: J Orthop Trauma. 2019 Oct;33(10):e409. doi: 10.1097/BOT.0000000000001596. PMID: 29664882.
3. Pradhan A, Najefi A, Patel A, Vris A, Heidari N, Malagelada F, Parker L, Jeyaseelan L. Complications after talus fractures: A trauma centre experience. Injury. 2023 Feb;54(2):772-777. doi: 10.1016/j.injury.2022.12.013. Epub 2022 Dec 15. PMID: 36543737.
4. Schwartz AM, Runge WO, Hsu AR, Bariteau JT. Fractures of the Talus: Current Concepts. Foot Ankle Orthop. 2020 Feb 13;5(1):2473011419900766. doi: 10.1177/2473011419900766. PMID: 35097362; PMCID: PMC8697161.
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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10. Ohl X, Harisboure A, Hemery X, Dehoux E. Long-term follow-up after surgical treatment of talar fractures: Twenty cases with an average follow-up of 7.5 years. Int Orthop. 2011 Jan;35(1):93-9. doi: 10.1007/s00264-009-0930-y. Epub 2009 Dec 22. PMID: 20033158; PMCID: PMC3014484.
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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.
13. Rinonapoli G, Pace V, Ruggiero C, Ceccarini P, Bisaccia M, Meccariello L, Caraffa A. Obesity and Bone: A Complex Relationship. Int J Mol Sci. 2021 Dec 20;22(24):13662. doi: 10.3390/ijms222413662. PMID: 34948466; PMCID: PMC8706946.
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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

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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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3. Porst H. Review of the current status of low intensity extracorporeal shockwave therapy (Li-ESWT) in erectile dysfunction (ED), Peyronie’s disease (PD), and sexual rehabilitation after radical prostatectomy with special focus on technical aspects of the different marketed ESWT devices including personal experiences in 350 patients. Sex Med Rev 2021;9:93-122.
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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.

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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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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

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How to Cite this article: Senes S, Staudacher G, Iglesias S, Moya D, Goyeneche R | Treatment of a femoral shaft non-union in a pediatric patient with focused shock waves | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 36-38.

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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.

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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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