A novel treatment method for ankylosing spondylitis combined with sacroiliac joint bone marrow edema
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 41-46 | Leilei Zhang, Xuanye Zhu, Haonan Ling, Wanyi Zhang, Ying Zhang, Youwen Liu, Xiantao Chen
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.101
Author: Leilei Zhang [1], Xuanye Zhu [2], Haonan Ling [1], Wanyi Zhang [1], Ying Zhang [1], Youwen Liu [1], Xiantao Chen [1]
[1] Center of hip Surgery, Henan Luoyang Orthopedic-Traumatological Hospital, Orthopedic Hospital of Henan Province, Luoyang, China.
[2] Henan University of Traditional Chinese Medicine, zhengzhou, China.
Address of Correspondence
Dr. Center of Hip Surgery, Henan Luoyang Orthopedic-Traumatological Hospital, Orthopedic Hospital of Henan Province, No. 82, South Qiming Road, 471002, Luoyang, China.
E-mail: luoyangzhenggu@139.com
Abstract
Objective: To investigate whether high-energy extracorporeal shock wave therapy (ESWT) combined with conventional oral medicine as a potential novel therapeutic approach for the treatment of ankylosing spondylitis (AS)combined with sacroiliac joint bone marrow edema.
Materials & Methods: 40 patients were divided into two groups and were treated with or without ESWT in combination with conventional oral medicine. A visual analog scale (VAS) score of spinal pain, as well as indicators of spinal mobility, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores, inflammatory index (C-reactive protein, blood cell sedimentation rate), and other indicators were compared between the two groups. The Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system was used to evaluate pain and structural damage in the sacroiliac joint.
Results: (1) After one month of treatment (T1), VAS, BASDAI, BASFI, and SPARCC scores were lower in both groups than at the start of treatment (T0) (P < 0.05), with greater decreases observed in the treatment group (P < 0.05). (2) Also, at T1, indicators of spinal mobility for the two groups were improved (P < 0.05). (3) ESR and C-reactive protein levels for the two groups decreased significantly at T1 versus T0 (P < 0.05).
Conclusion: ESWT combined with oral medication can significantly relieve pain and improve clinical functional symptoms for patients with AS. It can also reduce sacroiliac joint bone marrow edema and control the inflammatory reaction in the sacroiliac joint, which represents a novel, effective, reliable, and safe clinical treatment therapeutic method.
Keywords: Ankylosing spondylitis, Sacroiliac joint, extracorporeal shock wave therapy, oral medicine.
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| How to Cite this article: Zhang L, Zhu X, Ling H, Zhang W, Zhang Y, Liu Y, Chen X | A novel treatment method for ankylosing spondylitis combined with sacroiliac joint bone marrow edema | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 41-46. |
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Clinical Study on Appropriate Energy of Extracorporeal Shock Wave for Rotator Cuff Non-calcific Tendinopathy Treatment
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 47-51 | Jin Xi, Li Jie, Li Jin, Luo Hao, Zhang Liheng
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.103
Author: Jin Xi [1], Li Jie [2], Li Jin [2], Luo Hao [2], Zhang Liheng [2]
[1] Graduate Union of Changchun University of Chinese Medicine, Changchun China.
[2] Department of Sports medicine and joint surgery Jilin Provincial People’s Hospital, Changchun, China.
Address of Correspondence
Dr. Zhang Liheng,
Department of Sports medicine and joint surgery Jilin Provincial People’s Hospital, Changchun, China.
E-mail: 1987174487@qq.com
Abstract
Objective: This study aims to investigate the short-term clinical efficacy of extracorporeal shock waves with different energy levels on rotator cuff non-calcific tendinopathy.
Materials and Methods: A total of 139 patients with rotator cuff rotator non-calcific tendinopathy were randomly divided into eight groups based on the different energy levels of the Dornier Aries smart focus shock wave therapy device: Level 5, 2000 shocks (0.062 mJ/mm2), Level 6, 2000 shocks (0.084 mJ/mm2), Level 7, 2000 shocks (0.096 mJ/mm2), Level 8, 2000 shocks (0.117 mJ/mm2), Level 5, 3000 shocks (0.062 mJ/mm2), Level 6, 3000 shocks (0.084 mJ/mm2), Level 7, 3000 shocks (0.096 mJ/mm2), and Level 8, 3000 shocks (0.117 mJ/mm2). Each
group received shock wave treatment corresponding to the respective energy level and shock count. The visual analogue scale (VAS) and Constant-Murley score (CMS) were compared before and 1, 2, and 4 weeks after treatment to determine the short-term efficacy.
Results: The VAS scores of all groups significantly decreased at 1, 2, and 4 weeks after treatment compared to before treatment. The VAS score of the Level 7, 2000 shocks (0.096 mJ/mm2) group was significantly lower than the other groups (P < 0.05). The CMS scores of all groups significantly increased at 1, 2, and 4 weeks after treatment compared to before treatment. The CMS score of the Level 7, 2000 shocks (0.096 mJ/mm2) group was significantly higher than the other groups (P < 0.05). There was significant statistical difference in the effective rate among the eight groups (P > 0.05). No serious adverse reactions were observed in any group before or after the treatment.
Conclusion: Extracorporeal shock wave therapy for rotator cuff rotator non-calcific tendinopathy can alleviate shoulder joint pain, improve shoulder joint function, and enhance patients quality of life with good efficacy. The optimal therapeutic effect was observed at an energy level of 0.096 mJ/mm2 and 2000 shocks.
Keywords: Rotator cuff injury, Rotator cuff non-calcific tendinopathy, Extracorporeal shock wave therapy
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| How to Cite this article: Xi J, Jie L, Jin L, Hao L, Liheng Z | Clinical Study on Appropriate Energy of Extracorporeal Shock Wave for Rotator Cuff Non-calcific Tendinopathy Treatment. | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 47-51. |
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Extracorporeal Shockwave in Combination with Arthroscopic Surgery for Calcified Supraspinatus Tendinitis
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 52-56 | Jin Li, Jie Li, Xi Jin, Sheng Liu, Shaohong Zhao, Liheng Zhang
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.105
Author: Jin Li [1, 2], Jie Li [1], Xi Jin [2], Sheng Liu [2], Shaohong Zhao [2], Liheng Zhang [1]
[1] Department of Sports Medicine and Joint Surgery, Jilin Province People’s Hospital, , Changchun, China,
[2] Graduate Union of Changchun University of Chinese Medicine, Changchun, China.
Address of Correspondence
Dr. Liheng Zhang,
Department of Sports Medicine and Joint Surgery, Jilin Province People’s Hospital, Changchun, China.
E-mail: 1987174487@qq.com
Abstract
Objective: Exploring the therapeutic effect of extracorporeal shockwave combined with Arthroscopic Surgery on calcified supraspinatus tendinitis.
Materials and Methods: Sixty patients with calcific supraspinatus tendinitis who received treatment in our hospital from June 2022 to June 2023 were randomly divided into two groups. All patients had disease lasting more than 6 months. The control group received extracorporeal shockwave therapy (ESWT), while the observation group, after undergoing arthroscopic debridement of calcific deposits in the joint, began receiving the same ESWT as the control group after 2 weeks. The differences in Visual Analog Scale (VAS) score, University of California at Los Angeles (UCLA) score, and Constant–Murley score between the two groups before and after treatment were recorded and compared.
Results: Before treatment, there was no significant difference in VAS score, UCLA score, and Constant–Murley Scale (CMS) score between the two groups of patients (P > 0.05); compared with before treatment, both groups of patients showed a significant decrease in VAS scores after 1 and 2 months of treatment (P < 0.05). After 1 and 2 months of treatment, the VAS scores of the observation group were significantly lower than the ones of the control group (P < 0.05). Compared with before treatment, the UCLA score and CMS score of both groups of patients significantly increased after 1 and 2 months of treatment (P < 0.05). After 1 and 2 months of treatment, the UCLA score and CMS score of the observation group were significantly higher than those of the control group (P < 0.05).
Conclusion: The combination of extracorporeal shockwave and arthroscopy has a significant therapeutic effect on calcified supraspinatus tendinitis, helping to improve shoulder joint function and effectively alleviate pain in patients.
Keywords: Extracorporeal shockwave, Arthroscopy, Calcifying supraspinatus tendinitis, Shoulder joint function, Pain.
References:
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| How to Cite this article: Li J, Li J, Jin X, Liu S, Zhao S, Zhang L | Extracorporeal Shockwave in Combination with Arthroscopy for Calcified Supraspinatus Tendonitis | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 52-56. |
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Extracorporeal Shock Wave Treatment for Calcifying Tendinitis of the Shoulder: A case report and literature review
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 57-61 | Dehui Song, Chengxin Li, Wei Sun, Yu Zhou, Fuqiang Gao, Li Zirong
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.107
Author: Dehui Song [1], Chengxin Li [2], Wei Sun [3, 4], Yu Zhou [1], Fuqiang Gao [3], Li Zirong [1]
[1] Peking University Health Science Center, China-Japan Friendship School of Clinical Medicine, Beijing, China,
[2] Department of Orthopedic, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China,
[3] Department of Orthopedics, Shockwave Center, China-Japan Friendship Hospital, Beijing, China,
[4] Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Address of Correspondence
Dr. Wei Sun,
Department of Orthopedics, Shockwave Center, China-Japan Friendship Hospital, Beijing, China/Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
E-mail: wei.sun@pennmedicine.upenn.edu
Abstract
Background: Calcifying tendinitis of the shoulder (CTS), also known as rotator cuff calcific tendinitis, is a self-limiting shoulder disorder primarily characterized by inflammation surrounding hydroxyapatite crystal deposits in the tendons of the rotator cuff. Given the specific characteristics of the shoulder joint and the uncertainty regarding the efficacy of various treatments for CTS, no standardized treatment protocol has been established. However, numerous studies have demonstrated that extracorporeal shock wave therapy (ESWT) is effective in alleviating pain and improving joint function in patients with calcifying tendinitis of the shoulder. The therapeutic process works using high-energy shock waves to break down deposits of calcification, reduce local inflammation, and promote tissue healing. The purpose of this article is to present a case of symptomatic calcifying tendinopathy involving the rotator cuff and further demonstrate that ESWT has good efficacy in the treatment of musculoskeletal diseases.
Results: In this case, a 39-year-old woman with a 6-month history of shoulder pain and limited range of motion (ROM) was diagnosed with calcifying tendinitis of the shoulder. A single session of shock wave therapy resulted in the complete resolution of calcific deposits and the patient’s symptoms, leading to a return to her normal ROM and improved quality of life.
Conclusion: ESWT has been shown to be a good alternative to surgery for the treatment of calcifying tendinitis of the shoulder (CTS). It can significantly alleviate pain, improve shoulder function, and reduce the average size of calcium deposits. It might be the first choice for treating shoulder tendinopathy due to its effectiveness and safety.
Keywords: Calcifying tendinitis, Shoulder pain, Extracorporeal shock wave treatment, Case report
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13. Santamato A, Beatrice R, Micello MF, Fortunato F, Panza F, Bristogiannis C, et al. Power doppler ultrasound findings before and after focused extracorporeal shock wave therapy for achilles tendinopathy: A pilot study on pain reduction and neovascularization effect. Ultrasound Med Biol 2019;45:1316-23.
14. 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.
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| How to Cite this article: Song D, Li C, Sun W, Zhou Y, Gao F, Zirong L | Extracorporeal Shock Wave Treatment for Calcifying Tendinitis of the Shoulder: A case report and literature review. | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 57-61. |
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Comparison of Radial Pressure Waves and Focused Extracorporeal Shock Waves in Treatment of Osteoarthritis of the Knee
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 62-66 | Xichun Sun, Suoli Cheng, Xianghua Xiong, Zhengcheng Wang
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.109
Author: Xichun Sun [1], Suoli Cheng [1], Xianghua Xiong [2], Zhengcheng Wang [1]
[1] Department of Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China,
[2] Department of Orthopedics, People’s Hospital of Liangping District, Chongqing, China.
Address of Correspondence
Dr. Suoli Cheng,
Department of Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China.
E-mail: chengsuoli@126.com
Abstract
Objective: The aim of this study is to investigate and compare the clinical efficacy of radial pressure waves and focused external shock wave therapy for knee osteoarthritis (KOA).
Materials and Methods: From October 2020, 90 patients aged 45–65 years old with Kellgren and Lawrence classification (K-L) stage I and II of KOA were selected in our hospital or randomly assigned to 3 groups with 30 cases in each group. One group was treated with antiinflamatory medication. The other two groups received one course of treatment (once a week, 4 times in total) performed by using radial focused shock
waves respectively, and follow-up was conducted by telephone and outpatient review 3, 6, and 9 months after the treatment. Visual Analog Scale (VAS) and Western Ontario McMaster Osteoarthritis Index (WOMAC) osteoarthritis score were used before and after treatment.
Results: (1) VAS, WOMAC, and evaluation indexes of both treated groups were better than those of the control group (oral drug group); (3) The score of the radial group was significantly different from that of the focused group (P > 0.05).
Conclusion: (1) Focused and radial pressure waves (RPW) have good clinical therapeutic effect on early KOA (2) Comparison of long-term effect: focused shock waves are more significant than radial (3) Radial pressure waves area good indication in relatively young patients, short course of disease (within 1 year), and K-L stage I an II. (4) In older patients, with more than a year of symptoms and K-L stages II and III, focal waves are more effective than radial waves. (5) Patients with acute onset and night pain or accompanied by obvious effusion can first take nonsteroidal
drugs orally continuously for a week, and the treatment effect is better. During treatment, the drugs can be continued or stopped according to the specific conditions. When synovial edema and effusion of the joint decreased, the conventional parameters were used for treatment.
Keywords: Knee osteoarthritis, Extracorporeal shock wave therapy, Radial Pressure Waves
References:
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| How to Cite this article: Sun X, Cheng S, Xiong X, Wang Z | Comparison of Radial Pressure Waves and Focused Extracorporeal Shock Waves in Treatment of Osteoarthritis of the Knee. | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 62-66. |
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Clinical Study on the Treatment of Long Bone Fracture Non-union with Extracorporeal Shock Wave Therapy Combined with Platelet-rich Plasma
Original Article | Vol 3 | Issue 2 | July-December 2023 | page: 67-72 | RongDa Xu, JiaHui Li, ZhenCun Cai, Zhi Li, ZhiHao Liang, YuanLong Li, Lin Shen, HongLiang Tu, HongYu Zhou, Han Sun, Pei Li
DOI: https://doi.org/10.13107/jrs.2023.v03.i02.111
Author: RongDa Xu [1], JiaHui Li [1], ZhenCun Cai [1], Zhi Li [2], ZhiHao Liang [2], YuanLong Li [3], Lin Shen [4], HongLiang Tu [5], HongYu Zhou [6], Han Sun [7], Pei Li [1]
[1] Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China,
[2] Department of Orthopedics Surgery, Centro Hospitalar Conde de São Januário, Rua do Almirante Costa Cabral, Macau, China,
[3] Department of Orthopedics Surgery, Guangdong General Hospital, Yuexiu District, Guangzhou, China,
[4] Department of Hand Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China,
[5] Department of Orthopedics Surgery, 242 Hospital Affiliated to Shenyang Medical College, Huanggu District, China,
[6] Department of Orthopedics Surgery, Shenyang Orthopedic Hospital, Dadong District, Shenyang, China,
[7] Department of Orthopedics Surgery, Liaoyang County Central Hospital, Liaoyang, China.
Address of Correspondence
Dr. Pei Li,
Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, China.
E-mail: peili4421@gmail.com
Abstract
Objective: The objective of the study was to evaluate of the therapeutic efficacy of extracorporeal shock wave therapy (ESWT) combined with platelet-rich plasma (PRP) injection in patients with long bone fracture non-union.
Material and Methods: A total of 36 patients identified with long bone fracture non-union treated from September 2020 to September 2023 were enrolled into this study. Employing a random number table method, they were randomly divided into three groups, with 12 cases in each group. Based on the treatment modality, the groups were categorized as the ESWT group, PRP group, and combination ESWT + PRP group. Routine radiographs and musculoskeletal ultrasound were obtained before treatment and at 3-, 6-, and 9-month post-treatment intervals to observe for bone callus formation and assess fracture line imaging scores with the aim to evaluate the treatment efficacy of each group.
Results: With the extension of treatment time, the bone callus and fracture line imaging scores of the three groups gradually increased (P < 0.05). At 3-, 6-, and 9-month post-treatment, the scores of the ESWT combined with the PRP group were significantly better than those of the singular ESWT group and PRP group, and the differences were statistically significant (P < 0.05).
Conclusion: Therapy with singular ESWT, singular PRP, and combination ESWT + PRP has demonstrated effective improvement in fracture healing for patients with long bone fracture non-union. The synergistic effects of combination therapy were more significant, surpassing the efficacy of singular ESWT or PRP applications. The combined use of ESWT and PRP represents a safe and promising alternative treatment for long-bone fracture non-union, making it a compelling choice in the context of fracture healing.
Keywords: Extracorporeal shock wave therapy, Platelet-rich plasma, Non-union of fracture.
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| How to Cite this article: Xu R, Li J, Cai Z, Li Z, Liang Z, Li Y, Shen L, Tu H, Zhou H, Sun H, Li P | Clinical Study on the Treatment of Long Bone Fracture Non-union with Extracorporeal Shock Wave Therapy Combined with Platelet-rich Plasma. | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 67-72. |
