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Archives of Orthopaedic and Trauma Surgery

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01-04-2012 | Orthopaedic Outcome Assessment

Extracorporeal shock wave therapy in early osteonecrosis of the femoral head: prospective clinical study with long-term follow-up

Authors: Maria Chiara Vulpiani, Mario Vetrano, Donatella Trischitta, Laura Scarcello, Federica Chizzi, Giuseppe Argento, Vincenzo Maria Saraceni, Nicola Maffulli, Andrea Ferretti

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2012

Abstract

Introduction

Extracorporeal shock wave therapy (ESWT) may exert beneficial effects in avascular necrosis of femoral head (AVNFH).

Patients

The current study evaluated the effectiveness of ESWT in reducing pain and in slowing down the progression of bone damage in 36 patients with unilateral AVNFH of stage Association Research Circulation Osseous (ARCO) I, II and III. At the beginning of the study, 10 hips were classified as stage I, 11 as stage II and 15 as stage III. Each treatment cycle included four sessions, with 2,400 impulses each administered at 0.50 mJ/mm², at 48–72 h intervals. Follow-up examinations were scheduled at 3, 6, 12 and then 24 months.

Method

Clinical assessments included assessment of pain scores, Harris Hip Scores and Roles and Maudsley score. Plain radiographs and magnetic resonances of the hip were used to evaluate the size of the lesion, the extent of collapse of subchondral bone, and degenerative changes of the hip joint.

Results

Patients from ARCO stage I group and stage II group achieved significantly better results than patients from ARCO stage III group at all follow-up time points (p < 0.005). During the follow-up period, 10 of the 15 stage III ARCO patients received an arthroplasty. ARCO stages I and II lesions were unchanged on radiographs and on magnetic resonance images.

Conclusion

ESWT in ARCO stages I and II may help to prevent progression of the area of avascular necrosis and manage pain.

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Title: Extracorporeal shock wave therapy in early osteonecrosis of the femoral head: prospective clinical study with long-term follow-up
Authors: Maria Chiara Vulpiani
Mario Vetrano
Donatella Trischitta
Laura Scarcello
Federica Chizzi
Giuseppe Argento
Vincenzo Maria Saraceni
Nicola Maffulli
Andrea Ferretti
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1444-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Extracorporeal shock wave therapy in early osteonecrosis of the femoral head: prospective clinical study with long-term follow-up

Abstract

Introduction

Patients

Method

Results

Conclusion

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Springer Medicine

Abstract

Introduction

Patients

Method

Results

Conclusion

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