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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-06-2013 | Sports Medicine

ESWT for tendinopathy: technology and clinical implications

Authors: Henk van der Worp, Inge van den Akker-Scheek, Hans van Schie, Johannes Zwerver

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2013

Abstract

Purpose

The general consensus that tendinopathy, at least in the chronic stage, is mainly a degenerative condition and inflammation plays a minor role has led to a shift from treatments that target inflammation towards treatment options that promote regeneration. One of these treatments is extracorporeal shockwave therapy (ESWT), a physical therapy modality that uses pressure waves to treat tendinopathy. This review was undertaken to give an overview of the literature concerning this treatment, and special attention is given to the differences between focused and radial ESWT.

Methods

A narrative description of wave characteristics, generation methods and in vitro effects of ESWT is given. The literature on ESWT as a treatment for one common tendinopathy, patellar tendinopathy, was systematically reviewed.

Results

Waves that are generated for focused and radial ESWT have very different physical characteristics. It is unclear how these characteristics are related to clinical effectiveness. Studies into the biological effects of ESWT have mainly used focused shockwave therapy, showing a number of effects of shockwaves on biological tissue. The systematic review of studies into the clinical effects of ESWT for patellar tendinopathy showed conflicting evidence for its effectiveness.

Conclusion

Physical characteristics of focused and radial waves differ substantially, but effect on clinical effectiveness is unclear. Whereas in vitro studies often show the effects of ESWT on tendon tissue, results of clinical studies are inconsistent. Based on the review of the literature, suggestions are given for the use of ESWT in clinical practice regarding timing and treatment parameters.

Level of evidence

IV.

Available only for authorised users

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Title: ESWT for tendinopathy: technology and clinical implications
Authors: Henk van der Worp
Inge van den Akker-Scheek
Hans van Schie
Johannes Zwerver
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-2009-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ESWT for tendinopathy: technology and clinical implications

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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