Effectiveness of extracorporeal shock wave therapy in bone marrow edema syndrome of the hip

D'Agostino, Cristina; Romeo, Placido; Lavanga, Vito; Pisani, Salvatore; Sansone, Valerio

doi:10.1007/s00296-014-2991-5

Cited by 40 publications

(35 citation statements)

References 43 publications

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“…The technique has mainly been used for the treatment of plantar fasciitis, 48 but effects on BML at the hip have also been reported with significant pain relief and functional improvement of the hip and reduction in BME. 49,50 Proponents of this method claim that the mechanical shocks improve blood flow in the area, thereby reducing or alleviating BMLs. The shocks could, however, also increase microdamage in the area, which-if BML signifies bone repair-is counterintuitive.…”

Section: Surgicalmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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Section: Surgicalmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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“…The effects of SWT on osteonecrosis of the femoral head (ONFH) were evaluated in 12 studies (4 RCTs) published between 2001 and 2018. These studies included 325 (404 hips) participants with stage I-III ONFH according to the Association Research Circulation Osseous (ARCO) classification as the main inclusion criterion, except for one study [59] that included ARCO stage I only. The main exclusion criteria were late ARCO stages, infection, advanced arthritis, neoplastic disease or blood coagulation disorders.…”

Section: Osteonecrosis Of the Femoral Headmentioning

confidence: 99%

The effects of shockwave therapy on musculoskeletal conditions based on changes in imaging: a systematic review and meta-analysis with meta-regression

Al-Abbad

Allen

Morris

et al. 2020

BMC Musculoskelet Disord

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Background: Shockwave therapy (SWT) is a commonly used intervention for a number of musculoskeletal conditions with varying clinical outcomes. However, the capacity of SWT to influence pathophysiological processes and the morphology of affected tissues remains unclear. The objective of the current review is to evaluate changes in imaging outcomes of musculoskeletal conditions following SWT. Methods: A comprehensive search of Medline, Embase, Cochrane Controlled Trials Register, CINAHL and SportDiscus was conducted from inception to October 2018. Prospective clinical trials evaluating the effectiveness of SWT based on changes in imaging outcomes were eligible for inclusion. Articles were evaluated independently for risk of bias using the Cochrane Risk of Bias list and the Methodological Index for Non-Randomized Studies. Random-effects meta-analysis and meta-regression with a priori determined covariates was conducted for each condition to determine potential predictors of SWT effects. Results: Sixty-three studies were included, with data from 27 studies available for effect size pooling. Meta-analyses and meta-regression on imaging outcomes were performed for rotator cuff calcific tendinitis (n = 11), plantar fasciitis (n = 7) and osteonecrosis of the femoral head (n = 9). There was an overall reduction in the size of measured lesion following SWT (MD 8.44 mm (95%CI 4.30, 12.57), p < 0.001) for calcium deposit diameter, (MD 0.92 mm (95%CI 0.03, 1.81), p = 0.04) for plantar fascia thickness and (MD 4.84% (95%CI -0.06, 9.75), p = 0.05) for lesion size in femoral head osteonecrosis. Meta-regression showed no influence of SWT dosage parameters, however, baseline lesion size was an independent predictor for changes in imaging outcomes. Conclusions: SWT altered the morphology of musculoskeletal conditions, potentially reflecting changes in underlying pathophysiological processes. The parameters of SWT dosage are not significant predictors of changes in imaging outcomes. Lack of adequate reporting of imaging outcomes limited the conclusions that could be drawn from the current review. Registration number: PROSPERO CRD42018091140.

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“…Alle fem pasienter er blitt bedre. Det foreligger også rapporter om bruk av prostasyklinanaloger (24), hyperbar oksygenterapi (25) og trykkbølgebehandling (26), men per i dag finnes det ingen behandling hvor effekten er tilstrekkelig dokumentert til å kunne anbefales.…”

Section: Figur 1 Diffust Benmargsødem I Høyre Caput Og Collum Femorisunclassified