How to Read Radial Pressure Wave and Shock Wave Scientific Literature Without Perishing in the Attempt

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Review Article | Vol 5 | Issue 2 |  July-December 2025 | page: 42-46 | Daniel Moya, Mani Singh, Lauro Schledorn de Camargo

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.183

Open Access License: CC BY-NC 4.0

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

Submitted Date: 08 Aug 2025 , Review Date: 27 Sep 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Daniel Moya [1], Mani Singh [2], Lauro Schledorn de Camargo [3]

[1] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina.
[2] Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, United States.
[3] Orthopedic Surgeon, LC Clinic Jundiaí – SP, Brazil .

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

Abstract

Publications on shock wave therapy have experienced exponential growth since the beginning of the 21st century. While this has had a positive effect by providing a wealth of information, it has also generated confusion and misunderstandings. It is essential that readers be aware of the significant discrepancies and serious errors, even within the basic sciences related to this therapeutic tool.
In a literature review, we discuss examples of the most frequent errors.
Critical reading is the surest way to avoid adopting false concepts.
Keywords: Shock wave, Radial pressure waves, Literature review, Critical reading

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: Moya D, Singh M, Camargo LSD. How to Read Radial Pressure Wave and Shock Wave Scientific Literature Without Perishing in the Attempt. Journal of Regenerative Science. July-December 2025;5(2):42-46.

 

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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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Extracorporeal Shock Wave Therapy and Radial Pressure Wave Therapy in Carpal Tunnel Syndrome: A Narrative Review of Clinical Outcomes and Therapeutic Implications

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Review Article | Vol 5 | Issue 2 |  July-December 2025 | page: 32-38 | Armando Tonatiuh Ávila García, Karen Chacón Morales, Ana Lilia Villagrana Rodríguez, Daniel Miller Serano, Diego Alberto Rojo Orozco, Diana Hazel Araiza Quintana

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.179

Open Access License: CC BY-NC 4.0

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

Submitted Date: 05 Aug 2025, Review Date: 18 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Armando Tonatiuh Ávila García [1], Karen Chacón Morales [1], Ana Lilia Villagrana Rodríguez [1], Daniel Miller Serano [1], Diego Alberto Rojo Orozco [1], Diana Hazel Araiza Quintana [1]

 

[1] Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.

Address of Correspondence
Armando Tonatiuh Ávila García,
Department of Physical Medicine and Rehabilitation, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Guadalajara, Jalisco, México.
E-mail: atavila@hcg.gob.mx

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and a frequent cause of pain, functional impairment, and reduced quality of life. Although conservative management remains the first-line approach for mild-to-moderate disease, optimal non-invasive treatment strategies continue to be investigated. Extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) have emerged as potential therapeutic alternatives due to their biological effects on nerve regeneration, inflammation, and tissue healing.
Objective: The objective of the study is to synthesize and critically evaluate the current evidence regarding the efficacy and safety of ESWT and RPWT in the management of CTS.
Methods: A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science databases. Studies evaluating the effects of ESWT and RPWT in patients with CTS were included, encompassing randomized controlled trials, observational studies, and systematic reviews. Outcomes of interest included pain intensity, functional status, and electrophysiological parameters.
Results: The available evidence suggests that ESWT and RPWT are associated with significant improvements in pain relief, functional outcomes, and nerve conduction parameters in patients with mild-to-moderate CTS. Both ESWT and RPWT modalities demonstrated clinical benefits, with improvements observed in Visual Analog Scale scores, Boston Carpal Tunnel Questionnaire outcomes, and electrophysiological measures. Across studies, ESWT and RPWT were generally well tolerated, with minimal and transient adverse effects. Comparisons with conventional treatments, including splinting and corticosteroid injection, indicate comparable or superior outcomes for ESWT and RPWT in selected patient populations.
Conclusion: ESWT and RPWT represent promising non-invasive treatment options for CTS, offering meaningful clinical benefits with a favorable safety profile. Although current evidence supports its use in mild-to-moderate disease, further high-quality randomized controlled trials are warranted to establish optimal treatment parameters and long-term efficacy.
Keywords: Carpal Tunnel Syndrome, Extracorporeal Shock Wave Therapy, Radial Pressure Wave Therapy, Median Nerve.`

References:

1. Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016 Nov;15(12):1273-1284. doi: 10.1016/S1474-4422(16)30231-9. Epub 2016 Oct 11. PMID: 27751557.
2. Zamborsky R, Kokavec M, Simko L, Bohac M. Carpal Tunnel Syndrome: Symptoms, Causes and Treatment Options. Literature Reviev. Ortop Traumatol Rehabil. 2017 Jan 26;19(1):1-8. doi: 10.5604/15093492.1232629. PMID: 28436376.
3. Yesuf T, Borsamo A, Aragie H, Asmare Y. Prevalence of carpal tunnel syndrome and its associated factors among patients with musculoskeletal complaints: a single-center experience from Eastern Ethiopia. BMC Musculoskelet Disord. 2025 Jul 9;26(1):667. doi: 10.1186/s12891-025-08859-7. PMID: 40634896; PMCID: PMC12239355.
4. Rotaru-Zavaleanu AD, Lungulescu CV, Bunescu MG, Vasile RC, Gheorman V, Gresita A, Dinescu VC. Occupational Carpal Tunnel Syndrome: a scoping review of causes, mechanisms, diagnosis, and intervention strategies. Front Public Health. 2024 May 22;12:1407302. doi: 10.3389/fpubh.2024.1407302. PMID: 38841666; PMCID: PMC11150592.
5. Joshi A, Patel K, Mohamed A, Oak S, Zhang MH, Hsiung H, Zhang A, Patel UK. Carpal Tunnel Syndrome: Pathophysiology and Comprehensive Guidelines for Clinical Evaluation and Treatment. Cureus. 2022 Jul 20;14(7):e27053. doi: 10.7759/cureus.27053. PMID: 36000134; PMCID: PMC9389835.
6. Preston DC, Shapiro BE. Neuropatías craneales. En: Preston DC, Shapiro BE, editores. Electromiografía y Trastornos Neuromusculares: Correlaciones Clínicas, Electrofisiológicas y Ecográficas. 4ª ed. Barcelona: Elsevier; 2021. p. 323-57.
7. Wielemborek PT, Kapica-Topczewska K, Bielecki M, Kułakowski R, Mirowska-Guzel D, Kochanowicz J, Kułakowska A. Manual therapy compared to surgery in the treatment of moderate carpal tunnel syndrome. Postep Psychiatr Neurol. 2024 Dec;33(4):248-256. doi: 10.5114/ppn.2024.147102. Epub 2025 Feb 25. PMID: 40070424; PMCID: PMC11891758.
8. Urits I, Gress K, Charipova K, Orhurhu V, Kaye AD, Viswanath O. Recent Advances in the Understanding and Management of Carpal Tunnel Syndrome: a Comprehensive Review. Curr Pain Headache Rep. 2019 Aug 1;23(10):70. doi: 10.1007/s11916-019-0811-z. PMID: 31372847.
9. Fernández-de-Las-Peñas C, Arias-Buría JL, Ortega-Santiago R, De-la-Llave-Rincón AI. Understanding central sensitization for advances in management of carpal tunnel syndrome. F1000Res. 2020 Jun 15;9:F1000 Faculty Rev-605. doi: 10.12688/f1000research.22570.1. PMID: 32595941; PMCID: PMC7308881.
10. Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician. 2016 Dec 15;94(12):993-999. PMID: 28075090.
11. Dahlin LB, Zimmerman M, Calcagni M, Hundepool CA, van Alfen N, Chung KC. Carpal tunnel syndrome. Nat Rev Dis Primers. 2024 May 23;10(1):37. doi: 10.1038/s41572-024-00521-1. PMID: 38782929.
12. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop. 2014 Aug 20;49(5):429-36. doi: 10.1016/j.rboe.2014.08.001. PMID: 26229841; PMCID: PMC4487499.
13. Yang L, Li X, Li S, Yang J, Meng D. Effect of extracorporeal shock wave therapy on nerve conduction: a systematic review and meta-analysis. Front Neurol. 2024 Nov 22;15:1493692. doi: 10.3389/fneur.2024.1493692. PMID: 39650239; PMCID: PMC11621010.
14. Li W, Dong C, Wei H, Xiong Z, Zhang L, Zhou J, Wang Y, Song J, Tan M. Extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome: a meta-analysis. J Orthop Surg Res. 2020 Nov 23;15(1):556. doi: 10.1186/s13018-020-02082-x. PMID: 33228746; PMCID: PMC7685634.
15. Chen Y, Han B, Zhang X, Guo C, Han Q, Zhang Z, Hou S. Conservative Treatments of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-analysis. Arch Phys Med Rehabil. 2025 Sep;106(9):1447-1458. doi: 10.1016/j.apmr.2025.04.002. Epub 2025 Apr 30. PMID: 40315975.
16. Vongvachvasin P, Phakdepiboon T, Chira-Adisai W, Siriratna P. Efficacy of focused shockwave therapy in patients with moderate-to-severe carpal tunnel syndrome: a preliminary study. J Rehabil Med. 2024 Feb 8;56:jrm13411. doi: 10.2340/jrm.v56.13411. PMID: 38332536; PMCID: PMC10865893.
17. Menekseoglu AK, Korkmaz MD, Segmen H. Clinical and electrophysiological efficacy of extracorporeal shock-wave therapy in carpal tunnel syndrome: a placebo-controlled, double-blind clinical trial. Rev Assoc Med Bras (1992). 2023 Feb 17;69(1):124-130. doi: 10.1590/1806-9282.20220943. PMID: 36820719; PMCID: PMC9937620.
18. Xu D, Ma W, Jiang W, Hu X, Jiang F, Mao C, Wang Y, Fang L, Luo N, Li H, Lou Z, Gan K. A randomized controlled trial: comparing extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome. Int Orthop. 2020 Jan;44(1):141-146. doi: 10.1007/s00264-019-04432-9. Epub 2019 Oct 26. PMID: 31655883.
19. Habibzadeh A, Mousavi-Khatir R, Saadat P, Javadian Y. The effect of radial shockwave on the median nerve pathway in patients with mild-to-moderate carpal tunnel syndrome: a randomized clinical trial. J Orthop Surg Res. 2022 Jan 25;17(1):46. doi: 10.1186/s13018-022-02941-9. PMID: 35078486; PMCID: PMC8786622.
20. Sağlam G, Çetinkaya Alişar D, Özen S. Physical therapy versus radial extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome: A randomized-controlled study. Turk J Phys Med Rehabil. 2022 Mar 1;68(1):126-135. doi: 10.5606/tftrd.2022.7187. PMID: 35949973; PMCID: PMC9305635.
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22. Koçak Ulucaköy R, Yurdakul FG, Bodur H. Extracorporeal shock wave therapy as a conservative treatment option for carpal tunnel syndrome: A double-blind, prospective, randomized, placebo-controlled study. Turk J Phys Med Rehabil. 2020 Nov 9;66(4):388-397. doi: 10.5606/tftrd.2020.3956. PMID: 33364558; PMCID: PMC7756840.
23. Turgut MC, Saglam G, Toy S. Efficacy of extracorporeal shock wave therapy for pillar pain after open carpal tunnel release: a double-blind, randomized, sham-controlled study. Korean J Pain. 2021 Jul 1;34(3):315-321. doi: 10.3344/kjp.2021.34.3.315. PMID: 34193637; PMCID: PMC8255150.

How to Cite this article: Richmond C, Thieu V, Singh M. Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft. Journal of Regenerative Science. July-December 2025;5(2):32-38

 

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Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction with Patellar Tendon Autograft

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Case Report | Vol 5 | Issue 2 |  July-December 2025 | page: 28-31 | Connor Richmond, Vincent Thieu, Mani Singh

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.177

Open Access License: CC BY-NC 4.0

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

Submitted Date: 19 Sep 2025, Review Date: 02 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Connor Richmond [1], Vincent Thieu [1], Mani Singh [2]

[1] NewYork-Presbyterian Hospital, Columbia University Department of Rehabilitation and Regenerative Medicine & Weill Cornell Department of Rehabilitation Medicine
[2] Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, United States.

Address of Correspondence
Na Chen,
Department of Internal Medicine, Peking University Hospital, Beijing, China. E-mail: 18901267905@163.com; CN09558@pku.edu.cn.

Abstract

Purpose: Extracorporeal Extracorporeal shockwave therapy (ESWT) has been increasingly utilized for musculoskeletal pathology, including conditions such as patellar tendinopathy. More recently, there is growing evidence to support the use of ESWT following anterior cruciate ligament (ACL) reconstruction to support post-operative rehabilitation and optimize return to sport.
We report a case of a 21-year-old collegiate male athlete with a relevant history of Osgood–Schlatter disease who suffered from an acute ACL rupture and subsequently underwent ACL reconstruction (ACLR) using bone-patellar tendon-bone (BTB) autograft. His rehabilitation course was complicated by worsening anterior knee pain consistent with patellar tendinopathy. His symptomatic knee was treated with four sessions of ESWT using both focused and radial devices. He was able to return to play 1 month later with improvement in pain, quadriceps strength, and on-field sports-specific function.
ESWT may serve as an adjunct to conventional rehabilitation following ACLR, particularly in patients experiencing patellar tendon-related pain.
Keywords: Patellar Tendinopathy; Anterior cruciate ligament reconstruction; Focused shock waves, Radial pressure waves

References:

1. Bram JT, Magee LC, Mehta NN, Patel NM, Ganley TJ. Anterior cruciate ligament injury incidence in adolescent athletes: A systematic review and meta-analysis. Am J Sports Med 2021;49:1962-72.
2. Musahl V, Karlsson J. Anterior cruciate ligament tear. N Engl J Med 2019;380:2341-8.
3. Rousseau R, Labruyere C, Kajetanek C, Deschamps O, Makridis KG, Djian P. Complications after anterior cruciate ligament reconstruction and their relation to the type of graft: A prospective study of 958 cases. Am J Sports Med 2019;47:2543-9.
4. Zhang S, Wen A, Li S, Yao W, Liu C, Lin Z, Jin Z, Chen J, Hua Y, Chen S, Li Y. Radial Extracorporeal Shock Wave Therapy Enhances Graft Maturation at 2-Year Follow-up After ACL Reconstruction: A Randomized Controlled Trial. Orthop J Sports Med. 2023 Feb 2;10(9):1-12. 23259671221116340. doi: 10.1177/23259671221116340. PMID: 36760537; PMCID: PMC9902647.
5. Wang CJ, Ko JY, Chou WY, Hsu SL, Ko SF, Huang CC, et al. Shockwave therapy improves anterior cruciate ligament reconstruction. J Surg Res 2014;188:110-8.
6. Rahim M, Ooi FK, Shihabudin MT, Chen CK, Musa AT. The effects of three and six sessions of low energy extracorporeal shockwave therapy on graft incorporation and knee functions post anterior cruciate ligament reconstruction. Malays Orthop J 2022;16:28-39.
7. Song Y, Che X, Wang Z, Li M, Zhang R, Wang D, et al. A randomized trial of treatment for anterior cruciate ligament reconstruction by radial extracorporeal shock wave therapy. BMC Musculoskelet Disord 2024;25:57.
8. Weninger P, Thallinger C, Chytilek M, Hanel Y, Steffel C, Karimi R, et al. Extracorporeal shockwave therapy improves outcome after primary anterior cruciate ligament reconstruction with hamstring tendons. J Clin Med 2023;12:3350.
9. Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: A systematic review. Am J Sports Med 2015;43:752-61.
10. Schroeder AN, Tenforde AS, Jelsing EJ. Extracorporeal shockwave therapy in the management of sports medicine injuries. Curr Sports Med Rep 2021;20:298-305.
11. Van Leeuwen MT, Zwerver J, Van Den Akker-Scheek I. Extracorporeal shockwave therapy for patellar tendinopathy: A review of the literature. Br J Sports Med 2009;43:163-8.
12. Cheng L, Chang S, Qian L, Wang Y, Yang M. Extracorporeal shock wave therapy for isokinetic muscle strength around the knee joint in athletes with patellar tendinopathy. J Sports Med Phys Fitness 2019;59:822-7.

How to Cite this article: Richmond C, Thieu V, Singh M. Application of Extracorporeal Shockwave Therapy for Recalcitrant Patellar Tendinopathy Following Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft. Journal of Regenerative Science. July-December 2025;5(2):28-31.

 

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Visual Analysis of Research Progress and Trends in Extracorporeal Shock Wave Therapy for Coronary Heart Disease

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Original Article | Vol 5 | Issue 2 |  July-December 2025 | page: 20-27 | Na Chen

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.175

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: Na Chen [1]

[1] Department of Internal Medicine, Peking University Hospital, Beijing, China

Address of Correspondence
Na Chen,
Department of Internal Medicine, Peking University Hospital, Beijing, China. E-mail: 18901267905@163.com; CN09558@pku.edu.cn.

Abstract

Purpose: Extracorporeal shock wave therapy (ESWT) has emerged as a promising non-invasive intervention in cardiovascular disease (CVD) management, with increasing research interest over the past two decades. This study aimed to systematically analyze the research progress, hotspots, and development trends in ESWT for CVD using bibliometric methods, providing a comprehensive overview for subsequent research.
Methods: Literature related to ESWT and CVD was retrieved from the Web of Science Core Collection database, covering the period from 1999 to August 2025. The search strategy was defined as TS=([Shock wave OR Extracorporeal shock wave therapy OR ESWT] AND [Cardiovascular disease OR Coronary artery disease OR Myocardial ischemia OR Heart failure]). After excluding non-English studies, proceeding papers, retracted publications, and early access articles, 465 valid articles were included. Bibliometric analysis was performed using VOSviewer and CiteSpace software, focusing on publication trends, country/institution contributions, author collaborations, journal distributions, keyword co-occurrence, and cited references.
Results: A total of 465 publications involving 3019 authors from 1001 institutions across 55 countries were included, with 15,556 citations from 3104 sources. The annual number of publications has shown a steady growth trend since 2017. The United States (133 documents, 53.3 average citations) was the most influential country, followed by China (82 documents) and Germany (47 documents). Tohoku University (20 documents, 56.1 average citations) and Mayo Clinic (11 documents, 79.7 average citations) were leading institutions. Hiroaki Shimokawa and Hon-Kan Yip (18 documents each) were the most productive authors. Heart Rhythm (15 documents, 44.8 average citations) and Circulation (9 documents, 140.2 average citations) were core journals in this field. High-frequency keywords included “heart failure” (56 times), “coronary artery disease” (44 times), and “mortality” (41 times), with “outcome” being recent burst terms (2023–2025). The top-cited reference was a 2004 study on ESWT improving ischemia-induced myocardial dysfunction in pigs (87 citations).
Conclusion: ESWT for CVD is a rapidly developing research field, with the United States leading in academic influence. Current research focuses on myocardial ischemia, heart failure, and therapeutic efficacy/safety, while future trends may involve exploring mechanisms related to extracorporeal shock wave action and expanding clinical applications in comorbidities.
Keywords: Extracorporeal shock wave therapy, Cardiovascular disease, Bibliometrics, CiteSpace, VOSviewer

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How to Cite this article: Chen N . Visual analysis of research progress and trends in extracorporeal shock wave therapy for coronary heart disease. Journal of Regenerative Science. July-Decemnber 2025;5(2):20-27

 

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Guidelines for High-energy Focused Shock Wave Therapy in Non-traumatic Osteonecrosis of the Femoral Head in Adults (2025 Edition)

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Original Article | Vol 5 | Issue 2 |  July-December 2025 | page: 2-12 | Tianyang Liu, Wei Sun, Fuqiang Gao

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.171

Open Access License: CC BY-NC 4.0

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

Submitted Date: 05 Aug 2025, Review Date: 23 Sep 2025, Accepted Date: 09 Nov 2025 & Published: 30 Dec 2025

Author: Tianyang Liu [1], Wei Sun [2], Fuqiang Gao [1]
[1] Department of Orthopedics, Osteonecrosis and Hip Dysplasia Hip Preservation Center, China-Japan Friendship Hospital, Beijing, China.
[2] Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, USA.

Address of Correspondence
Dr. Fuqiang Gao,
Department of Orthopedics, Osteonecrosis and Hip Dysplasia Hip Preservation Center, China-Japan Friendship Hospital, Beijing, China.
E-mail: gaofuqiang@bjmu.edu.cn/gaofuqiang@hsc.pku.edu.cn

Abstract

Non-traumatic osteonecrosis of the femoral head (NONFH) is a common and refractory orthopedic disease that leads to disability and is a frequent cause of hip joint dysfunction and pain. This condition imposes a significant burden on patients, their families, and society. Extracorporeal shock wave therapy (ESWT) is a non-invasive, safe, and effective treatment that has been widely used in the clinical management of musculoskeletal diseases, including NONFH. However, the current application of ESWT for NONFH lacks a unified consensus regarding treatment protocols and evaluation methods, limiting its widespread adoption. Consequently, developing standardized, scientific, and effective ESWT interventions for patients with early- and mid-stage NONFH remains a critical concern for clinicians. These guidelines have been developed under the organization of the Third Medical Center of the Chinese PLA General Hospital and the China–Japan Friendship Hospital, with contributions from the Shock Wave Medical Professional Committee of the Chinese Research Hospital Association and experts in ONFH and ESWT. It references the latest domestic and international literature, integrates domestic clinical experience and actual conditions, and employs the modified 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence and grades of recommendation. Guidelines are developed under the guidance of the WHO Handbook for Guideline Development (2014 Edition) and the Chinese Principles for the Development and Revision of Clinical Guidelines (2022 Edition). The Appraisal of Guidelines for Research and Evaluation II (AGREE II), Reporting Items for Practice Guidelines in Healthcare, and the Appraisal of Guidelines for Research and Evaluation in China (AGREE-China) were also referenced for evaluation. Nine clinical questions of utmost concern to physicians were selected, leading to the formation of nine evidence-based recommendations. These guidelines aim to provide constructive recommendations and a basis for the promotion and application of ESWT in the treatment of NONFH, thereby enhancing the scientific rigor and standardization of ESWT.
Keywords: Shockwave, Extracorporeal shock wave therapy, Osteonecrosis of the femoral head, Evidence-based medicine, Physical therapy

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How to Cite this article: XLiu T, Sun W, Gao F. Guidelines for High-energy Focused Shock Wave Therapy in Non-traumatic Osteonecrosis of the Femoral Head in Adults (2025 Edition). July-Decemnber 2025;5(2):2-12.

 

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Efficacy and Safety of Icariin Capsules in Intervening Post-operative Bone Grafting for Hip Osteonecrosis in ARCO Stage II

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Original Article | Vol 5 | Issue 2 |  July-December 2025 | page: 13-19 | Yuanzhuo Xu, Yu Zhou, Wei Sun, Fuqiang Gao

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.173

Open Access License: CC BY-NC 4.0

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

Submitted Date: 19 Oct 2025, Review Date: 18 Nov 2025, Accepted Date: Nov 2025 & Published: 30 Dec 2025

Author: Yuanzhuo Xu [1],  Yu Zhou1 [1,2,3], Wei Sun [4], Fuqiang Gao [1,2,3]

[1] Department of Orthopedic Surgery, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
[2] Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA,
[3] Center for Hip Preservation, Osteonecrosis and Developmental Dysplasia of the Hip, China-Japan Friendship Hospital, Beijing, China,
[4] Department of Orthopedic Surgery, Capital Medical University, China-Japan Friendship School of Clinical Medicine, Beijing, China.

Address of Correspondence
Dr. Wei Sun,
Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
E-mail: wei.sun@pennmedicine.upenn.edu

Abstract

Introduction: Both hip-preserving surgery and pharmacological therapy can effectively improve symptoms in patients with early-stage osteonecrosis of the femoral head (ONFH) and are expected to delay the need for total hip arthroplasty. However, the clinical efficacy of combining hip-preserving surgery with drug therapy has not yet been widely substantiated. Therefore, we conducted a randomized clinical trial to compare the clinical outcomes of impacted bone graft (IBG) combined with Icariin (ICA) versus IBG alone.
Purposes: The aim of this study was to clinically observe and evaluate the interventional therapeutic effect of ICA in patients with corticosteroid-induced ONFH following hip-preserving surgery, by comparing the femoral head collapse rate with a placebo control group, thereby providing a reliable basis for expanding the clinical application indications of  ICA.
Materials and Methods: This was a prospective randomized clinical trial. Patients with early-stage steroid-induced ONFH (ARCO stage II) who underwent hip-preserving surgery were eligible. Between September 2021 and August 2022, we randomized 46 patients to receive either IBG plus ICA or IBG alone. At the 1-year follow-up, 87% of patients (20 out of 23) in both the IBG+ICA and IBG groups were available for assessment. The observed indicators included patient-reported outcome measures ([PROMs], including Harris Hip Score [HHS], the 36-item short form health survey [SF-36], and Visual Analog Scale [VAS]) and the progression of femoral head collapse on imaging, assessed preoperatively and within 1 year postoperatively. No significant differences were noted in baseline characteristics such as age, gender, affected side, and PROMs between the two groups.
Results: We found no statistically significant difference in the improvement of the HHS (4.7 ± 3.6 vs. 4.0 ± 3.5, respectively; mean difference 0.7 [95% confidence interval [CI] −1.5–3.0]; P = 0.505) or the VAS score (0.28 ± 0.29 vs. 0.14 ± 0.25, respectively; mean difference 0.14 [95% CI −0.03–0.32]; P = 0.099) between the IBG + ICA group and the IBG group at 3 months postoperatively. However, significant differences began to emerge by 6 months postoperatively (HHS at 6 months: 8.4 ± 3.0 vs. 5.4 ± 2.8, respectively; mean difference 3.0 [95% CI 1.1–4.8]; P = 0.003; HHS at 12 months: 10.8 ± 3.3 vs. 7.7 ± 3.4, respectively; mean difference 3.1 [95% CI 1.0–5.3]; P = 0.005; VAS at 6 months: 0.48 ± 0.27 vs. 0.30 ± 0.17, respectively; mean difference 0.18 [95% CI 0.03–0.32]; P = 0.021; VAS at 12 months: 0.84 ± 0.26 vs. 0.50 ± 0.25, respectively; mean difference 0.34 [95% CI 0.18–0.51]; P < 0.001). Furthermore, the IBG+ICA group demonstrated a significantly greater improvement in the SF-36 score at 12 months postoperatively compared to the IBG group (7.9 ± 3.1 vs. 3.5 ± 3.2, respectively; mean difference 4.4 [95% CI 2.4–6.4]; P < 0.001). No significant difference in the progression of femoral head collapse was observed between the two groups. Furthermore, no drug-related adverse reactions were reported.
Conclusion: Based on the 1-year follow-up of the two groups of patients and the analysis results, IBG + ICA did not bring more significant clinical symptom improvement to the patients compared to IBG at 3 months postoperatively. However, from 6 months postoperatively, the former showed better clinical efficacy. There was no significant difference in the impact on the progression of femoral head collapse between the two intervention methods within the 1-year follow-up period postoperatively. The safety of ICA during the perioperative period has been confirmed. For patients with severe pain or poor quality of life due to early ONFH, IBG+ICA treatment may be a good choice to improve the patient’s pain and quality of life.
Keywords: Icariin, Impacted bone graft, Hip osteonecrosis, Outcomes, Statistical Package for the Social Sciences

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How to Cite this article: Xu Y, Sun W, Zhou Y, Gao F. Efficacy and safety of Icariin capsules in intervening post-operative bone grafting for hip osteonecrosis in ARCO stage II. Journal of Regenerative Science. July-Decemnber 2025;5(2):13-19.

 

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All Roads Lead to Rome

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Editorial | Vol 5 | Issue 2 |  July-December 2025 | page: 01 | Daniel Moya

DOI: https://doi.org/10.13107/jrs.2025.v05.i02.169

Open Access License: CC BY-NC 4.0

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

Submitted Date: 29 Jul 2025, Review Date: 25 Aug 2025, Accepted Date: 15 Nov 2025 & Published: 30 Dec 2025

Author: Daniel Moya [1]

[1] Department of Orthopaedics, Hospital Británico de Buenos Aires, Argentina

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

Editorial

The popular proverbial saying that all roads lead to Rome has a basis in reality. In 20 BC, Emperor Augustus built in the Roman forum a bronze monument covered in Bronze called “Milliarium Aureum,” which marked kilometer zero of the Roman roads. [1] The reference point was considered the origin of some 400 roads that extended for approximately 80,000 km, integrating the extent of the Roman Empire.
The first mention of this phrase is in the Middle Ages, in a text from 1175 that literally reads “Mille viae ducunt hominem per saecula Romam,” which translates to “A thousand roads lead a man to Rome forever.”[2] This road network had administrative, military, and commercial implications, but it also allowed a flow of people from different backgrounds that made the “Eternal City” the capital of the world for many centuries.
Unlike other great imperial capitals, Rome has managed to withstand the ups and downs of history and remain one of the international points of reference from a cultural, political, and economic point of view.
Therefore, it is no coincidence that Rome has been chosen as the venue for the next meeting of the International Federation of Shockwave Therapy.
On May 29th and 30th, 2026, with the organization of the International Federation of Shock Wave Therapy, the Societá Italiana di Terapia con Onde D’Urto and the Accademia di Medicina e Chirurgia Bioregenerativa, an international meeting on shockwave therapy and regenerative medicine will be held at the Ospedale Santo Spirito Monumental Complex. Located steps from the Vatican, the convention center stands in the oldest hospital in Europe, founded in Rome in the 8th century for Saxon pilgrims and rebuilt by Pope Innocent III in the 13th century [3].
The congress will have a very high academic level with the participation of world leaders from all corners of the planet.
Considering the scientific, tourist, and cultural attractions of the proposal, it is clear that by 2026, all roads of shock waves and regenerative medicine lead to Rome.

Information: comunicazione@glowagency.it

IFSWT26

References:

1. Mari, Ζ. s.v. “Miliarium Aureum”. Lexicon Topographicum Urbis Romae, vol III. Rome; 1996. pp: 250-51.
2. Martínez MA. All roads lead to Rome (Omnes viae Romam ducunt). Antiquitatem: History of Greece and Rome. November 30, 2015. Available from: https://www.antiquitatem.com/en/all-roads-lead-to-rome/ Last accessed: 20 July 2025
3. The Santo Spirito in Saxia Museum Hub. [updated 2025 Oct 10]
Available from: https://www.santospiritoinsassia.com/en/
Last accessed: 20 July 2025

How to Cite this article: Moya D. All roads lead to Rome. Journal of Regenerative Science.
July-December 2025; 5(2): 01.

 

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