Shockwave therapy for chronic Achilles tendinopathy: A double-blind, randomized clinical trial of efficacy

Rasmussen, Sten; Christensen, Marianne; Mathiesen, Iben; Simonson, Ole

doi:10.1080/17453670710015058

Cited by 145 publications

(167 citation statements)

References 35 publications

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“…Patients were followed up at 4, 8, and 12 weeks. AOFAS increased more over time in the intervention group than in the control, from 74 to 81 in the placebo group and from 70 to 88 in the intervention group [34]. Better results were seen in the intervention group at 8 and 12 weeks follow-up.…”

Section: Extracorporeal Shock Wave Therapysupporting

confidence: 48%

“…Interestingly, women showed the best outcome, an unexpected finding. The authors concluded that ESWT appears to be a supplement for the treatment of chronic Achilles tendinopathy [34].…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

“…Rasmussen et al [34] compared low-energy ESWT versus sham therapy. Participants, 48 in all, were randomized to receive active or sham ESWT over 4 weeks.…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

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Shock wave therapy for Achilles tendinopathy

Wilson

Stacy

2010

Curr Rev Musculoskelet Med

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Achilles tendinopathy has been reported as the most common overuse injury in sports medicine clinics (Clement et al. Am J Sports Med 12: 179-184, 1984). Standard treatment regimens include activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading. There is a lack of consensus regarding treatment. Even so, most athletes will respond to this regimen. However, conservative management will prove to be inadequate for a subset of patients. When conservative therapy fails, other noninvasive treatment measures may be considered. Extracorporeal shock wave therapy (ESWT) has been used in soft-tissue disorders including lateral epicondylitis, plantar fasciitis, and calcific tendonitis of the shoulder. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is lacking. This article explores the role of shock wave therapy in the management of recalcitrant Achilles tendinopathy in patients attempting to avoid an invasive intervention.

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Section: Extracorporeal Shock Wave Therapysupporting

confidence: 48%

“…Interestingly, women showed the best outcome, an unexpected finding. The authors concluded that ESWT appears to be a supplement for the treatment of chronic Achilles tendinopathy [34].…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

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Shock wave therapy for Achilles tendinopathy

Wilson

Stacy

2010

Curr Rev Musculoskelet Med

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“…6 -10, 13 With good clinical success rates, indications of this treatment have expanded to other tendinopathies. 6 There are several theories for explaining the mechanism of shock wave effect in various cells and tissues.…”

Section: Introductionmentioning

confidence: 99%

Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes

Han¹,

Lee²,

Guyton³

et al. 2009

Foot Ankle Int

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Background: Little has been reported about the biologic effect of shock waves on human normal or pathologic tendon tissue. We hypothesized that inflammatory cytokine and MMP production would be down-regulated by shock wave stimulation. . IL-6 levels were higher in the diseased tenocytes as compared with normal tenocytes (44.10 ± 16.72 versus 0.21 ± 0.55 ng/ml, (p < 0.05). IL-1 levels in normal cells increased (2.24 ± 5.02 ng/ml to 9.31 ± 6.85 ng/ml) after shock wave treatment (p = 0.04). In diseased tenocytes, levels of MMP-1 (1.12 ± 0.23 to 0.75 ± 0.24 ng/ml; p = 0.04) and MMP-13 (1.43 ± 0.11 to 0.80 ± 0.15 ng/ml; p = 0.04) were significantly decreased after shock wave treatment. The IL-6 level in diseased tenocytes was decreased (44.10 ± 16.72 to 14.66 ±

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“…Numerous materials and agents have been used as a mechanical barrier to envelop sutured tendons in attempts to minimize the adhesion formation after primary tendon repair. Currently, the modalities used for preventing adhesions without affecting the healing process include; human amniotic fluid, hyaluronic acid, alginate solution, mannose-6-phosphate, 5-fluorouracil, injection of growth factors or platelet concentrate, local application of extracorporeal shock wave therapy or ultrasound therapy, local injection of bone-marrow-derived mesenchymal stem cells, systemic administration of antiinflammatory drugs [7][8][9][10][11][12][13][14][15][16] . The use of a barrier during surgery to protect raw tissue surfaces has been shown to be one of the most effective methods of preventing tendon adhesions.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Single Application of Adcon Gel on Peritendinous Adhesion: An Experimental Study in Rabbits

Özden

Uruç

Duman

et al. 2014

J. Hard Tissue Biology.

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Peritendinous adhesions are serious complications after surgical repair of tendons and can lead to poor functional outcome. In the present study, the tensile strength of repaired tendons was measured biomechanically in two groups using a rabbit Achilles tendon model, and the effects of Adcon gel on peritendinous adhesions and tendon healing were examined by means of histological and mechanical analyses. In the treatment group, the Achilles tendon was transected, followed by a primary repair using a modified Kessler technique, and Adcon gel was injected between the tendon and skin of the right leg. The same operation was done for the control group, and 1 mL of normal saline solution was applied locally in a similar fashion. The experimental protocols were approved by the local animal ethics committee. Microscopic evidence of the formation of adhesions and of inflammation was less in the treatment group than in the control group. There was no significant difference in the tensile load necessary to rupture the repaired tendons between the two groups. Adcon gel reduced the peritendinous adhesions histologically without impairing tendon healing, as determined with mechanical analyses. The use of Adcon gel may provide a simple means of preventing of postoperative peritendinous adhesions, thereby offering a beneficial effect on tendon repair.

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Shockwave therapy for chronic Achilles tendinopathy: A double-blind, randomized clinical trial of efficacy

Abstract: Interpretation Extracorporal shock-wave therapy appears to be a supplement for the treatment of chronic Achilles tendinopathy.

Cited by 145 publications

References 35 publications

Shock wave therapy for Achilles tendinopathy

Shock wave therapy for Achilles tendinopathy

Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes

Effects of a Single Application of Adcon Gel on Peritendinous Adhesion: An Experimental Study in Rabbits

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