Subscribe to RSS
DOI: 10.1055/s-0037-1618193
Die muskuloskelettale extrakorporale Stoßwellentherapie
Musculoskeletal extracoporeal shock wave therapyPublication History
Publication Date:
27 December 2017 (online)

Zusammenfassung
In den vergangenen 20 Jahren hat sich die extrakorporale Stoßwellentherapie (ESWT) nach intensiven weltweiten Forschungsanstrengungen zur Therapiemethode der ersten Wahl bei zahlreichen orthopädisch-unfallchirurgischen Erkrankungen entwickelt, einschließlich der plantaren Fasziitis, der lateralen Epikondylopathie, der Tendinosis calcarea der Schulter und der Pseudarthrose langer Röhrenknochen. Zuletzt hinzugekommen sind patellare Tendinopathie, Achillestendinopathie und avaskuläre Hüftkopfnekrose. Der Artikel beleuchtet den aktuellen Forschungsstand zur biologischen Wirkweise extrakorporaler Stoßwellen im Allgemeinen, und die klinische Anwendung bei der Plantarfasziitis im Besonderen.
Summary
Shock wave application in urology (lithotripsy) was primarily used to disintegrate kidney stones, whereas shock wave therapy in orthopedics is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shock wave therapy (ESWT) in musculoskeletal disorders has been around for more than two decades and is primarily used in the treatment of sports-related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and Achilles tendinopathy. The vast majority of the published papers showed positive and beneficial effects, with success rates ranging from 65 % to 91 %, and complications low and negligible. FDA first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.
-
Literatur
- 1 Haupt G. et al. Influence of shock waves on fracture healing. Urology 1992; 39: 529-532.
- 2 Wang CJ. Extracorporeal shock wave therapy in musculoskeletal disorders. J Orthop Surg Res 2012; 7: 11-18.
- 3 Hausdorf J. et al. Molekulare Grundlagen zur schmerzvermittelnden Wirkung extrakorporaler Stoßwellen. Schmerz 2004; 18: 492-497.
- 4 Rompe J-D. Extrakorporale Stoßwellentherapie. Grundlagen, Indikation, Anwendung. London, Glasgow, Weinheim, New York, Tokyo, Melbourne, Madras: Chapman und Hall; 1997
- 5 Schmitz C, DePace R. Pain relief by extracorporeal shockwave therapy: an update on the current understanding. Urol Res 2009; 37: 231-234.
- 6 Jaalouk D, und Lammerding J. Mechanotransduction gone awry. Nat Rev Mol Cell Biol 2009; 10: 63-73.
- 7 Hofmann A. et al. Extracorporeal shock wave-mediated changes in proliferation, differentiation, and gene expression of human osteoblasts. J Trauma 2008; 65: 1402-1410.
- 8 Hofmann A. et al. Cell viability, osteoblast differentiation, and gene expression are altered in human osteoblasts from hypertrophic fracture non-unions. Bone 2008; 42: 894-906.
- 9 Raabe O. et al. Effect of extracorporeal shock wave on proliferation and differentiation of equine adipose tissue-derived mesenchymal stem cells in vitro. A J Stem Cell 2013; 2: 62-73.
- 10 Contaldo C. et al. Radial pressure waves mediate apoptosis and functional angiogenesis during wound repair in ApoE deficient mice. Microvasc Res 2012; 84: 24-33.
- 11 Ohtori S. et al. Shockwave application to rat skin induces degeneration and reinnervation of sensory nerve fibres. Neurosci Lett 2001; 315: 57-60.
- 12 Takahashi N. et al. Second application of low-energy shock waves has a cumulative effect on free nerve endings. Clin Orthop Relat Res 2006; 443: 315-319.
- 13 Kenmoku T. et al. Degeneration and recovery of the neuromuscular junction after application of extracorporeal shockwave therapy. J Orthop Res 2012; 30: 1660-1665.
- 14 Rompe J-D. et al. Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis. J Orthop Res 2005; 23: 931-941.
- 15 Labek G. et al. Influence of local anesthesia and energy level on the clinical outcome of extracorporeal shock wave-treatment of chronic plantar fasciitis. Z Orthop Ihre Grenzgeb 2005; 143: 240-246.
- 16 Klonschinski T. et al. Application of local anesthesia inhibits effects of low-energy extracorporeal shock wave treatment (ESWT) on nociceptors. Pain Med 2011; 12: 1532-1537.
- 17 Haake M. et al. Extracorporeal shockwave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ 2003; 327: 75.
- 18 Haake M. Extracorporeal shockwave therapy in the treatment of lateral epicondylitis: a randomized multicenter trial. J Bone Joint Surg Am 2002; 84-A: 1982-1991.
- 19 Dizon JN. et al. Effectiveness of Extracorporeal Shock Wave Therapy in Chronic Plantar Fasciitis: A Meta-analysis. Am J Phys Med Rehabil. 2013 Apr 2. [Epub ahead of print]
- 20 Rompe J-D. et al. Evaluation of low-energy extracorporeal shock-wave application for treatment of chronic plantar fasciitis. J Bone Joint Surg Am 2002; 84-A: 335-341.
- 21 Wang CJ. et al. Shock wave therapy for patients with plantar fasciitis: a one-year follow-up study. Foot Ankle Int 2002; 23: 204-207.
- 22 Gerdesmeyer L. et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med 2008; 36: 2100-2109.
- 23 Buchbinder R. et al. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA 2002; 288: 1364-1372.
- 24 Speed CA. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial. J Orthop Res 2003; 21: 937-940.
- 25 Rompe J-D. et al. Plantar fascia-specific stretching versus radial shock-wave therapy as initial treatment of plantar fasciopathy. J Bone Joint Surg Am 2010; 92: 2514-2522.
- 26 Saxena A. et al. Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete. Muscle Ligaments Tendons J 2012; 2: 312-316.
- 27 Weil Jr LS. et al. Extracorporeal shock wave therapy for the treatment of chronic plantar faciitis: indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg 2002; 41: 166-172.
- 28 Greve JM. et al. Comparison of radial shock waves and conventional physiotherapy for treating plantar fasciitis. Clinics (Sao Paulo, Brazil) 2009; 64: 97-103.
- 29 Yucel I. et al. Comparison of high-dose extracorporeal shock wave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis:. J Am Podi Med Assoc 2010; 100: 105-110.
- 30 Rompe J-D. Effectiveness of radial shock wave treatment or tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain. SICOT-Kongress; Dubai: 2012
- 31 Rompe J-D. et al. Shock wave therapy for chronic plantar fasciopathy. Br Med Bull 2007; 81–82: 183-208.
- 32 Rompe J-D. Plantar fasciopathy. Sports Med Arthrosc 2009; 17: 100-104.