The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion

Abstract

Background: Knee osteoarthritis (KOA) is a major cause leading to chronic bone and muscle pain. Extracorporeal shock wave therapy (ESWT) has been applied in treating KOA in recent years. Methods: From April 2016 to April 2017, 82 patients were diagnosed with KOA that received ESWT were selected as the ESWT group. The treatment parameters were as follows, 2.0 bar, 0.25 mJ/mm 2 , and 8 Hz/s for twice a week for 4 weeks continuously. In addition, 104 patients receiving oral administration of nonsteroidal anti-inflammatory drugs (NSAIDs) from April 2015 to April 2016 were also selected as the NSAIDs group. At 4, 8, 12, and 16 weeks upon the completion of treatment, the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were adopted to evaluate the changes in pain and function of patients in both groups. For the ESWT group, the 50-m quick walk time and gait analysis were applied to observe the functional recovery at 4, 8, 12, and 16 weeks upon the completion of treatment; meanwhile, patients were followed up by magnetic resonance imaging (MRI) at 24 weeks upon the completion of treatment, so as to observe the cartilage changes. Results: Differences in VAS, 4, 8, and 12 weeks after treatment were statistically significant compared with that before treatment (4.59 ± 0.5, P < .05; 2.55 ± 0.5, P < .05; 4.39 ± 0.49, P < .05). Differences in 4, 8, and 12 weeks after treatment were statistically significant compared with that before treatment (90.41 ± 6.64, P < .05; 59.94 ± 3.19, P < .05; 90.49 ± 6.87, P < .05). Gait analysis suggested differences in 50 m walk time, walking speed, swing phase, and stance phase 8 weeks after treatment were statistically significant compared with that before treatment (36.23 ± 4.08, P < .05; 1.25 ± 0.09, P < .05; 58.56 ± 0.87, P < .05; 41.44 ± 0.87, P < .05). Differences in the VAS and WOMAC at 4 and 8 weeks after treatment between ESWT group and NASIDs group were not statistically significant. Conclusions: The ESWT has potential in reducing pain and improving knee function, and the therapeutic effects may peak at 8 weeks after the completion of treatment. Further research is needed to arrive at a definitive conclusion.

Retrospective Study of Rehabilitation Exercise Combined with Extracorporeal Shock Wave Therapy for Knee Osteoarthritis

“…In this study, compared with before treatment, after 5 weeks of treatment, the VAS score, WOMAC score, and Lequesne index score of the RE group and NRE group were significantly decreased, while ROM score and JOA score were significantly increased. The results of this study are similar to those of previous reports, and indicate that ESWT can reduce the clinical symptoms of KOA patients and improve knee joint function and quality of life of patients [ 28 – 32 ].…”

Biophysical Stimulation in Athletes’ Joint Degeneration: A Narrative Review

“…Wang C. et al observed improved tissue distributions, including cortical bone, cancellous bone, and fibrous tissue, in many studies using extracorporeal shockwaves to the subchondral bone of the medium tibia condyle. ESWT increased BMP-2 and osteocalcin expression in OA rats, which is usually linked with cell proliferation and extracellular matrix synthesis in healthy osteoblasts [66]. The immunohistochemical examination revealed that the expression of Dickkopf-related protein 1 (DKK-1)-a regulator of osteoblast activity-was considerably greater in OA and significantly decreased after ESWT therapy; these findings show that shock wave stimulation can boost subchondral bone anabolism and improve trabecular microarchitecture.…”

Healthcare and Scientific Treatment of Knee Osteoarthritis

“…ere are many current physical treatments, such as electromagnetic therapy [28], acupuncture [29], ultrasound [30], massage [31], spa [32], cupping [33], yoga [34], and laser [35], but there are great differences in the treatment effect on different individuals, and their effect is to relax tense muscles, promote local blood circulation, improve function of the knee joint, and promote absorption and discharge of inflammatory substances.…”