Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis

Hsieh, Chi Kun; Chang, Chao Jui; Liu, Zhao Wei; Tai, Ta-Wei

doi:10.1007/s00264-020-04489-x

Cited by 22 publications

(17 citation statements)

References 31 publications

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“…[ 8 ] Knee OA not only leads to a reduction in the quality of life of individuals but also has an impact on the entire social health and care system, which is even considered by many as a public health crisis due to the impact of sick leave, unemployment, early retirement and treatment costs. [ 3 , 9 , 10 ]…”

Section: Introductionmentioning

confidence: 99%

“…Patients with knee OA may choose surgery, medication, or non-medication to relieve symptoms. [ 3 , 11 ] Non-steroidal anti-inflammatory drugs (NSAIDs) are the main treatment in the clinic and were recommended in the clinical practice guidelines for knee OA treatment published by the American Academy of Orthopaedic Surgeons for all patients except those receiving surgical treatment. [ 12 ] However, in the long run, regardless of the toxicity of the drugs themselves, long-term use of these drugs will bring serious adverse reactions to patients, such as gastrointestinal ulcers, digestive system bleeding, and cardiovascular and cerebrovascular side effects .…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis

Liu

Wang

et al. 2020

Medicine

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Objective: To evaluate the effects and safety of intra-articular injection of mesenchymal stem cells on patients with knee osteoarthritis by a systematic review and meta-analysis. Methods: PubMed, EMBASE, and Cochrane Library were retrieved. An assessment of the risk of bias was done through the Cochrane Collaborative Bias Risk Tool, publication bias was assessed by plotting funnel plots and Egger tests. Pain and functional improvements in patients with knee osteoarthritis were determined by changes in VAS scores and WOMAC scores at baseline and follow-up endpoints. For the evaluation of MRI, the WORMS score and changes in cartilage volume were used. In addition, the number of adverse events in the intervention group and the control group were counted to explore the safety. Results: A total of 10 randomized controlled trials involving 335 patients were included. In the pooled analysis, compared with the control groups, the VAS scores of MSC groups decreased significantly (MD,−19.24; 95% CI: −26.31 to −12.18, P < .00001. All of the WOMAC scores also improved significantly: the total scores (SMD, − 0.66; 95% CI: − 1.09 to −0.23, P = .003), pain scores (SMD, − 0.46; 95% CI: − 0.75 to −0.17, P = .002), stiffness scores (SMD, −0.32; 95% CI: −0.64 to 0.00 P = 0.05), and functional scores (SMD, −0.36; 95% CI: −0.69 to −0.04, P = .03). Two studies with non-double-blind designs were the main source of heterogeneity. In terms of cartilage repair, there was no significant difference in the WORMS score, but there was a significant increase in cartilage volume in the MSC group (SMD, 0.69; 95% CI: 0.25 to 1.13, P = .002). The proportion of patients with adverse events in the MSCs treatment group was significantly higher than that in the control group (OR, 3.20; 95% CI: 1.50 to 6.83, P = .003). Conclusions: Intra-articular injection of mesenchymal stem cells is effective and safety to relieve pain and improve motor function of patients with knee osteoarthritis in a short term which is different to conclusions of previous study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis

Liu

Wang

et al. 2020

Medicine

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“…It was reported that at least 19% of American adults (age ≥ 45 years) suffer from this disease [ 2 ]. To delay or avoid surgical treatment, several non-surgical treatment options have been used to treat knee OA, such as extracorporeal shockwave therapy [ 3 ], intra-articular hyaluronic acid [ 4 ], intra-articular platelet-rich plasma [ 5 ], and foot orthoses [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy among Three Radiofrequency Ablation Techniques for Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Chou

Shen

et al. 2021

IJERPH

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Radiofrequency ablation (RFA) was first introduced for treating knee osteoarthritis (OA) in 2010 and has emerged as a minimally invasive treatment option. Three RFA techniques have been adopted for treating knee OA, including conventional, pulsed, and cooled RFA. However, the efficacy among different RFA techniques in the treatment of knee OA is still unclear. Three electronic databases were systematically searched for relevant articles, including PubMed, Embase, and Cochrane Library. A meta-analysis of articles that investigated the use of RFA techniques in the treatment of knee OA was conducted to pool the effect size in pain before and after treatment. A total of 20 eligible articles (including 605 patients) were included for our meta-analysis. After treatment, the patients had significant improvements in pain for all three RFA techniques when compared with the baseline level for the 1, 3-, and 6-month follow-ups (p < 0.00001). However, there were no significant differences in the efficacy among the three RFA techniques for all follow-up visits (p > 0.05). The three RFA techniques demonstrated a significant improvement in pain for up to 6 months after treatment. Comparing the efficacy of the three RFA techniques in the treatment of knee OA, our results showed that no significant differences in pain relief among the three RFA techniques were observed at the 1-, 3-, 6, and 12-month follow-up visits.

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“…Currently, active research is underway to determine the optimal loading parameters that contribute to the regeneration of bone and cartilage tissue. Shockwave therapy has been shown to be highly effective in the treatment of knee osteoarthritis [12][13][14]. In the treatment of knee arthritis, applicators are placed in the meniscus and subchondral bone tissue of the tibia [15].…”

Section: Introductionmentioning

confidence: 99%

Numerical Modeling of Shockwave Treatment of Knee Joint

Eremina¹,

Smolin²

2021

Materials

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Arthritis is a degenerative disease that primarily affects the cartilage and meniscus of the knee joint. External acoustic stimulation is used to treat this disease. This article presents a numerical model of the knee joint aimed at the computer-aided study of the regenerative effects of shockwave treatment. The presented model was verified and validated. A numerical analysis of the conditions for the regeneration of the tissues of the knee joint under shockwave action was conducted. The results allow us to conclude that to obtain the conditions required for the regeneration of cartilage tissues and meniscus (compressive stresses above the threshold value of 0.15 MPa to start the process of chondrogenesis; distortional strains above the threshold value of 0.05% characterized by the beginning of the differentiation of the tissues in large volumes; fluid pressure corresponding to the optimal level of 68 kPa to transfer tissue cells in large volumes), the energy flux density of therapeutic shockwave loading should exceed 0.3 mJ/mm2.

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Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis

Cited by 22 publications

References 31 publications

Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis

Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis

Comparison of Efficacy among Three Radiofrequency Ablation Techniques for Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Numerical Modeling of Shockwave Treatment of Knee Joint

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