Extracorporeal Shock Wave Therapy: Current Evidence

Abstract

Data from level 4 studies suggest that shock wave therapy seems to stimulate the healing process in delayed unions/nonunions. However, further investigations are required.

Efectividad de las ondas de choque radiales para el tratamiento de pseudoartrosis de astrágalo

“…reducción de la relación RANKL/OPG 16,17 . Aunque la pseudoartrosis es un problema desafiante para los ortopedistas, Zelle et al 18 mencionan en sus estudios que datos experimentales con ondas de choque estimulan la formación ósea in vitro y en vivo, de manera que se pueden obtener resultados exitosos; y estudios recientes, en 2013, demuestran los mismos resultados con el uso de ondas radiales en la formación de nuevo hueso 19 y el efecto osteogénico en humanos. 20 Finalmente, se puede concluir que, aunque hacen falta estudios, las ondas de choque radiales han demostrado la efectividad en el tratamiento de la pseudoartrosis, con recuperación anatómica y funcional, fundamentada en el proceso de mecano-transducción, de manera tal que los estímulos mecánicos generados por las ondas de choque extracorpóreas se traducen en efectos biológicos y cambios bioquímicos a este nivel.…”

The effects of explosion on the musculoskeletal system

“…However, there is a considerable body of literature on the use of low energy shock waves in extracorporeal shock wave therapy (ESWT) in orthopaedic applications (see reviews by McClure et al, 2004;Zelle et al, 2010), but the magnitude of therapeutic shock waves is reduced by approximately six orders of magnitude (Ogden et al, 2001). A range of biological changes have been observed at a molecular level using animal models and cells that indicate a key effect of ESWT is to stimulate osteogenesis through signalling processes and/ or growth factor production (Zelle et al, 2010). For example, studies of human osteoblasts stimulated with therapeutic-level shock waves demonstrated alterations in the regulation Massive soft tissue injury and sub-total / traumatic amputation of the limb.…”

Extracorporeal Shock Wave Therapy: Non‐Urological Indications and Recent Trends

“…The most important efects of shock waves are relection with pressure and tension powers at levels of diferent resistance and the production of cavitation bubbles in liquids. These bubbles collapse and produce local shear forces by high velocity liquid streams (so-called jet stream) [1,3,4]. The introduction of ESWL during the early 1980s markedly changed the management of urinary tract stones, and during the last two decades, the development of new techniques of ESWL has changed completely the way of treatment of patients with renal stones [5].…”