Background Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. Methods MEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted. Results Pain, function, and magnet resonance imaging results all improved across the studies — regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck’s disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = − 2.23, 95% CI − 2.58 to − 1.88, P < 0.0001; after 3–6 month: WMD = − 1.72, 95% CI − 2.52 to − 0.92, P < 0.00001) and function (after 1 month: WMD = − 1.59, 95% CI − 2.04 to − 1.14, P < 0.0001; after 3–6 month: WMD = − 2.06, 95% CI − 3.16 to − 0.96, P = 0.0002; after ≥ 12 month: WMD = − 1.20, 95% CI − 1.83 to − 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group. Conclusions Based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME. Trial registration PROSPERO, CRD42021201719. Registered 23 December 2020

BACKGROUND: Joint position sense test assess patient mobility and proprioceptive ability. Yet, application used under different conditions may biases reproduction error resulting in different therapeutic consequences. OBJECTIVE: To investigate knee angle reproduction test under different test conditions. METHODS: 25 healthy subjects (mean ± SD, age = 25 ± 2 years, activity level: 9 ± 2 training hours/week) performed knee angle reproduction test in the sitting and prone position, while changing the knee angle starting (i) from flexion and (ii) extension, (iii) inducing vibration on the semitendinosus tendon. RESULTS: Absolute mean knee angle reproduction error showed significant difference for body position and vibration (Position: 95% CI 0.71 to 2.32; p< 0.001. No Vibration & Vibration: 95% CI -1.71 to -0.12; p= 0.027). Relative knee angle reproduction error was significant different in all conditions (No Vibration & Vibration: 95% CI -3.30 to -0.45; p= 0.010. Body orientation: 95% CI 1.08 to 3.93; p< 0.001. Direction of movement: 95% CI 0.56 to 3.41; p= 0.007). CONCLUSION: Body orientation and movement direction influence the resulting knee angle reproduction error in healthy subjects. Practitioners are advised to use standardised test procedures when comparing different within- and between-patient results. Trial registration: DOI 10.17605/OSF.IO/AFWRP.

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