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J D Rompe - One of the best experts on this subject based on the ideXlab platform.

  • plantar fascia specific stretching versus radial Shock Wave Therapy as initial treatment of plantar fasciopathy
    Journal of Bone and Joint Surgery American Volume, 2010
    Co-Authors: J D Rompe, Christoph Schmitz, John P Furia, Angelo Cacchio, Lowell Weil, Joachim Haist, Volker Reiners, Nicola Maffulli
    Abstract:

    Background: Whether plantar fascia-specific stretching or Shock-Wave Therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously. Methods: One hundred and two patients with acute plantar fasciopathy were randomly assigned to perform an eight-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial Shock-Wave Therapy without local anesthesia, administered weekly for three weeks (Group II, n = 48). All patients completed the seven-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire. Patients were evaluated at baseline and at two, four, and fifteen months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment. Results: No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline. At two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with Shock-Wave Therapy (p < 0.001), as well as individually for item 2 (p = 0.002). Thirty-five patients (65%) in Group I versus fourteen patients (29%) in Group II were satisfied with the treatment (p < 0.001). These findings persisted at four months. At fifteen months after baseline, no significant between-group difference was measured. Conclusions: A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy radial Shock-Wave Therapy for the treatment of acute symptoms of proximal plantar fasciopathy. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

  • extracorporeal Shock Wave Therapy compared with surgery for hypertrophic long bone nonunions
    Journal of Bone and Joint Surgery American Volume, 2009
    Co-Authors: Angelo Cacchio, J D Rompe, Lucio Giordano, Olivo Colafarina, Emanuela Tavernese, Francesco Ioppolo, Stefano Flamini, Giorgio Spacca, Valter Santilli
    Abstract:

    Background: The authors of several studies have recommended extracorporeal Shock-Wave Therapy as an alternative to surgical treatment for long-bone nonunions. This study was performed to compare the results of extracorporeal Shock-Wave Therapy produced by two different devices with those of surgical treatment in the management of long-bone nonunions. Methods: One hundred and twenty-six patients with a long-bone nonunion were randomly assigned to receive either extracorporeal Shock-Wave Therapy (Groups 1 and 2) or surgical treatment (Group 3). The patients in the Shock-Wave groups received four treatments with 4000 impulses of Shock Waves with an energy flux density of 0.40 mJ/mm2 (Group 1) or 0.70 mJ/mm2 (Group 2). The patients in the three groups had similar demographic characteristics, durations of nonunion, and durations of follow-up. Radiographic results (the primary outcome) and clinical results (the secondary outcomes) were determined before and three, six, twelve, and twenty-four months after treatment. Results: The radiographic findings did not differ among the three groups of patients. At six months, 70% of the nonunions in Group 1, 71% of the nonunions in Group 2, and 73% of the nonunions in Group 3 had healed. Three and six months after treatment, the clinical outcomes in the two Shock-Wave groups were significantly better than those in the surgical group (p < 0.001). However, at both twelve and twenty-four months after treatment, there were no differences among the three groups, with the exception of the DASH score, which differed significantly between Groups 1 and 3 (p = 0.038) and between Groups 2 and 3 (p = 0.021) at twelve months. Conclusions: Extracorporeal Shock-Wave Therapy is as effective as surgery in stimulating union of long-bone hypertrophic nonunions and yields better short-term clinical outcomes. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

  • Shock Wave Therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder
    Clinical Orthopaedics and Related Research, 2001
    Co-Authors: J D Rompe, Jan Zoellner, B Nafe
    Abstract:

    A prospective quasirandomized study was performed to compare the effects of surgical extirpation (Group I, 29 patients) with the outcome after high-energy extracorporeal Shock Wave Therapy (Group II, 50 patients; 3000 impulses of an energy flux density of 0.6 mJ/mm 2 ) in patients with a chronic calcifying tendinitis in the supraspinatus tendon. Symptoms and demographic data of the two groups were comparable. According to the University of California Los Angeles Rating System, the mean score in Group I was 30 points with 75% good or excellent results after 12 months, and 32 points with 90% good or excellent results after 24 months. Radiologically, there was no calcific deposit in 85% of the patients after 1 year. In Group II, the mean score was 28 points with 60% good or excellent results after 12 months, and 29 points with 64% good or excellent results after 2 years. Radiologically, complete elimination of the deposit was observed in 47% of the patients after 1 year. Clinically, according to the University of California Los Angeles score, there was no significant difference between both groups at 1 year. At 2 years, there was a significantly better result in Group II. Both groups then were subdivided into patients who had a homogenous deposit as seen on radiographs and patients who had an inhomogenous deposit before treatment. Surgery was superior compared with high-energy Shock Wave Therapy for patients with homogenous deposits. For patients with inhomogenous deposits, high-energy extracorporeal Shock Wave Therapy was equivalent to surgery and should be given priority because of its noninvasiveness.

  • Shock Wave Therapy for tennis and golfer s elbow 1 year follow up
    Archives of Orthopaedic and Trauma Surgery, 1999
    Co-Authors: O Krischek, B Nafe, C Hopf, J D Rompe
    Abstract:

    Thirty patients with chronic medial epicondylitis were treated with low-energy Shock Waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal Shock-Wave Therapy is indicated in medial epicondylitis.

  • shoulder function after extracorporal Shock Wave Therapy for calcific tendinitis
    Journal of Shoulder and Elbow Surgery, 1998
    Co-Authors: J D Rompe, Rainer Burger, C Hopf, P Eysel
    Abstract:

    Abstract We report a controlled, prospective study that explored the effect of extracorporal Shock Waves of low- versus high-energy density in patients with chronic shoulder pain and calcific tendinitis. We assigned at random 100 patients who had had calcific tendinitis for more than 12 months to 2 groups to receive Shock Wave Therapy either of a low- or high-energy density. Group 1 received 1500 impulses of 0.06 mJ/mm2, whereas group 2 received 1500 impulses of 0.28 mJ/mm2. Unlike group 1, in which the Shock Wave application could be performed without local anesthesia, all patients in group 2 required brachial plexus anesthesia. The patients were reviewed at 6 and 24 weeks. Partial or complete disintegration of the calcareous deposit was observed in 50% of the patients in group 1 and 64% of the patients in group 2 (P

John P Furia - One of the best experts on this subject based on the ideXlab platform.

  • efficacy and safety of extracorporeal Shock Wave Therapy for orthopedic conditions a systematic review on studies listed in the pedro database
    British Medical Bulletin, 2015
    Co-Authors: Christoph Schmitz, Nikolaus B M Csaszar, Nicola Maffulli, Stefan Milz, Matthias Schieker, Jandirk Rompe, John P Furia
    Abstract:

    Background Extracorporeal Shock Wave Therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.

  • plantar fascia specific stretching versus radial Shock Wave Therapy as initial treatment of plantar fasciopathy
    Journal of Bone and Joint Surgery American Volume, 2010
    Co-Authors: J D Rompe, Christoph Schmitz, John P Furia, Angelo Cacchio, Lowell Weil, Joachim Haist, Volker Reiners, Nicola Maffulli
    Abstract:

    Background: Whether plantar fascia-specific stretching or Shock-Wave Therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously. Methods: One hundred and two patients with acute plantar fasciopathy were randomly assigned to perform an eight-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial Shock-Wave Therapy without local anesthesia, administered weekly for three weeks (Group II, n = 48). All patients completed the seven-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire. Patients were evaluated at baseline and at two, four, and fifteen months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment. Results: No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline. At two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with Shock-Wave Therapy (p < 0.001), as well as individually for item 2 (p = 0.002). Thirty-five patients (65%) in Group I versus fourteen patients (29%) in Group II were satisfied with the treatment (p < 0.001). These findings persisted at four months. At fifteen months after baseline, no significant between-group difference was measured. Conclusions: A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy radial Shock-Wave Therapy for the treatment of acute symptoms of proximal plantar fasciopathy. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

  • Shock Wave Therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal diaphyseal fractures
    Journal of Bone and Joint Surgery American Volume, 2010
    Co-Authors: John P Furia, Wolfgang Schaden, Paul J Juliano, Allison M Wade, Rainer Mittermayr
    Abstract:

    Background:The current “gold standard” for treatment of chronic fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal is intramedullary screw fixation. Complications with this procedure, however, are not uncommon. Shock Wave Therapy can be an effective treatment for fracture

  • low energy extracorporeal Shock Wave Therapy as a treatment for greater trochanteric pain syndrome
    American Journal of Sports Medicine, 2009
    Co-Authors: John P Furia, Jan D Rompe, Nicola Maffulli
    Abstract:

    Results: Mean pretreatment visual analog scores for the control and Shock Wave Therapy groups were 8.5 and 8.5, respectively. One, 3, and 12 months after treatment, the mean visual analog score for the control and Shock Wave Therapy groups were 7.6 and 5.1 (P < .001), 7 and 3.7 (P < .001), and 6.3 and 2.7 (P < .001), respectively. One, 3, and 12 months after treatment, mean Harris hip scores for the control and Shock Wave Therapy groups were 54.4 and 69.8 (P < .001), 56.9 and 74.8 (P < .001), and 57.6 and 79.9 (P < .001), respectively. At final follow-up, the number of excellent, good, fair, and poor results for the Shock Wave Therapy and control groups were 10 and 0 (P < .001), 16 and 12 (P < .001), 4 and 13 (P < .001), and 3 and 8 (P < .001), respectively. Chi-square analysis showed the percentage of patients with excellent (1) or good (2) Roles and Maudsley scores (ie, successful results) 12 months after treatment was statistically greater in the Shock Wave Therapy than in the control group (P < .001).

  • high energy extracorporeal Shock Wave Therapy as a treatment for insertional achilles tendinopathy
    American Journal of Sports Medicine, 2006
    Co-Authors: John P Furia
    Abstract:

    BackgroundResults of high-energy extracorporeal Shock Wave Therapy for the treatment of insertional Achilles tendinopathy are not determined. It is unclear how local anesthesia alters the outcome of this procedure.HypothesisExtracorporeal Shock Wave Therapy is an effective treatment for insertional Achilles tendinopathy. Local anesthesia field block adversely affects outcome.Study DesignCase control study; Level of evidence, 3.MethodsThirty-five patients with chronic insertional Achilles tendinopathy were treated with 1 dose of high-energy extracorporeal Shock Wave Therapy (ESWT group; 3000 Shocks; 0.21 mJ/mm2; total energy flux density, 604 mJ/mm2), and 33 were treated with nonoperative Therapy (control group). All extracorporeal Shock Wave Therapy procedures were performed using a local anesthesia field block (LA subgroup, 12 patients) or a nonlocal anesthesia (NLA subgroup, 23 patients). Evaluation was by visual analog score and by Roles and Maudsley score.ResultsOne month, 3 months, and 12 months afte...

B Nafe - One of the best experts on this subject based on the ideXlab platform.

  • Shock Wave Therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder
    Clinical Orthopaedics and Related Research, 2001
    Co-Authors: J D Rompe, Jan Zoellner, B Nafe
    Abstract:

    A prospective quasirandomized study was performed to compare the effects of surgical extirpation (Group I, 29 patients) with the outcome after high-energy extracorporeal Shock Wave Therapy (Group II, 50 patients; 3000 impulses of an energy flux density of 0.6 mJ/mm 2 ) in patients with a chronic calcifying tendinitis in the supraspinatus tendon. Symptoms and demographic data of the two groups were comparable. According to the University of California Los Angeles Rating System, the mean score in Group I was 30 points with 75% good or excellent results after 12 months, and 32 points with 90% good or excellent results after 24 months. Radiologically, there was no calcific deposit in 85% of the patients after 1 year. In Group II, the mean score was 28 points with 60% good or excellent results after 12 months, and 29 points with 64% good or excellent results after 2 years. Radiologically, complete elimination of the deposit was observed in 47% of the patients after 1 year. Clinically, according to the University of California Los Angeles score, there was no significant difference between both groups at 1 year. At 2 years, there was a significantly better result in Group II. Both groups then were subdivided into patients who had a homogenous deposit as seen on radiographs and patients who had an inhomogenous deposit before treatment. Surgery was superior compared with high-energy Shock Wave Therapy for patients with homogenous deposits. For patients with inhomogenous deposits, high-energy extracorporeal Shock Wave Therapy was equivalent to surgery and should be given priority because of its noninvasiveness.

  • Shock Wave Therapy for tennis and golfer s elbow 1 year follow up
    Archives of Orthopaedic and Trauma Surgery, 1999
    Co-Authors: O Krischek, B Nafe, C Hopf, J D Rompe
    Abstract:

    Thirty patients with chronic medial epicondylitis were treated with low-energy Shock Waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal Shock-Wave Therapy is indicated in medial epicondylitis.

  • low energy extracorporal Shock Wave Therapy for persistent tennis elbow
    International Orthopaedics, 1996
    Co-Authors: J D Rompe, Rainer Burger, C Hopf, J Heine, K Kullmer, B Nafe
    Abstract:

    Fifty patients who suffered from persistent tennis elbow for more than 12 months, and were referred for surgical treatment, were assigned at random to 2 groups of low-energy extracorporal Shock Wave Therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2; group II (controls) 30 impulses of 0.08 mJ/mm2. Follow up was after 3 and 12 weeks. We found no significant differences between the 2 groups before treatment, there was but significant relief of pain and improvement of function in group I with good or excellent outcome in 56% at the last evaluation.

  • extracorporal Shock Wave Therapy for calcifying tendinitis of the shoulder
    Clinical Orthopaedics and Related Research, 1995
    Co-Authors: J D Rompe, B Nafe, C Hopf, Frank Rumler, J Heine
    Abstract:

    During the past 2 years, 40 patients referred to the authors' hospital for persistent calcifying tendinitis of the shoulder were seen on prospective followup after undergoing a single extracorporal Shock Wave Therapy. During a single Therapy session, all patients received 1500 impulses of the energy density 0.28 mJ/mm 2 in plexus anesthesia. Followup examinations were done at 6 and 24 weeks. In 62.5% of the patients partial or complete disintegration of the deposit was observed. Statistical analysis showed significant improvement both of subjective and objective criteria. According to the Constant score, 60% of the patients reached normal values, and 72.5% of the patients had no or only occasional discomfort. Only 6 patients (15%) reported no improvement at the 24-week followup.

Alexander Stojadinovic - One of the best experts on this subject based on the ideXlab platform.

  • extracorporeal Shock Wave Therapy eswt for wound healing technology mechanisms and clinical efficacy
    Wound Repair and Regeneration, 2012
    Co-Authors: Rainer Mittermayr, Vlado Antonic, Joachim Hartinger, Hanna Kaufmann, Heinz Redl, Luc Teot, Alexander Stojadinovic, Wolfgang Schaden
    Abstract:

    For almost 30 years, extracorporeal Shock Wave Therapy has been clinically implemented as an effective treatment to disintegrate urinary stones. This technology has also emerged as an effective noninvasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Delayed/nonhealing or chronic wounds constitute a burden for each patient affected, significantly impairing quality of life. Intensive wound care is required, and this places an enormous burden on society in terms of lost productivity and healthcare costs. Therefore, cost-effective, noninvasive, and efficacious treatments are imperative to achieve both (accelerated and complete) healing of problematic wounds and reduce treatment-related costs. Several experimental and clinical studies show efficacy for extracorporeal Shock Wave Therapy as means to accelerate tissue repair and regeneration in various wounds. However, the biomolecular mechanism by which this treatment modality exerts its therapeutic effects remains unclear. Potential mechanisms, which are discussed herein, include initial neovascularization with ensuing durable and functional angiogenesis. Furthermore, recruitment of mesenchymal stem cells, stimulated cell proliferation and differentiation, and anti-inflammatory and antimicrobial effects as well as suppression of nociception are considered important facets of the biological responses to therapeutic Shock Waves. This review aims to provide an overview of Shock Wave Therapy, its history and development as well as its current place in clinical practice. Recent research advances are discussed emphasizing the role of extracorporeal Shock Wave Therapy in soft tissue wound healing.

  • prospective randomized phase ii trial of accelerated reepithelialization of superficial second degree burn wounds using extracorporeal Shock Wave Therapy
    Annals of Surgery, 2012
    Co-Authors: Christian Ottomann, Richard Thiele, Alexander Stojadinovic, Wolfgang Schaden, Philip T Lavin, Francis H Gannon, Michael H Heggeness, B Hartmann
    Abstract:

    Background:As extracorporeal Shock Wave Therapy (ESWT) can enhance healing of skin graft donor sites, this study focused on Shock Wave effects in burn wounds.Methods:A predefined cohort of 50 patients (6 with incomplete data or lost to follow-up) with acute second-degree burns from a larger study of

  • prospective randomized trial of accelerated re epithelization of skin graft donor sites using extracorporeal Shock Wave Therapy
    Journal of The American College of Surgeons, 2010
    Co-Authors: Christian Ottomann, Richard Thiele, Alexander Stojadinovic, Wolfgang Schaden, B Hartmann, Josh Tyler, Heike Maier
    Abstract:

    Background Extracorporeal Shock Wave Therapy may enhance revascularization and repair of healing soft tissue. Methods Between January 2006, and September 2007, 28 patients with acute traumatic wounds and burns requiring skin grafting were randomly assigned in a 1:1 fashion to receive standard topical Therapy (nonadherent silicone mesh [Mepitel, Molnlycke Health Care] and antiseptic gel [polyhexanide/octenidine]) to graft donor sites with (n = 13) or without (n = 15) defocused extracorporeal Shock Wave Therapy (ESWT, 100 impulses/cm 2 at 0.1 mJ/mm 2 ) applied once to the donor site, immediately after skin harvest. The randomization sequence was computer generated, and the patients were blinded to treatment allocation. The primary endpoint was time to complete donor site epithelialization and was determined by an independent blinded observer. Results Statistical tests indicated no unbalanced distribution of subject characteristics across the two study groups. Mean times to complete graft donor site epithelialization for patients who did and did not undergo ESWT were 13.9 ± 2.0 days and 16.7 ± 2.0 days, respectively (p = 0.0001). Conclusions For centers that apply nonadherent gauze dressings and topical antiseptics to skin graft donor sites, application of a single defocused Shock Wave treatment immediately after skin graft harvest can significantly accelerate donor site epithelialization.

  • Shock Wave Therapy for acute and chronic soft tissue wounds a feasibility study
    Journal of Surgical Research, 2007
    Co-Authors: Wolfgang Schaden, Richard Thiele, Christine Kolpl, Michael Pusch, Aviram Nissan, Christopher E Attinger, Mary E Maniscalcotheberge, George E Peoples, Eric A Elster, Alexander Stojadinovic
    Abstract:

    Background. Nonhealing wounds are a major, func- tionally-limiting medical problem impairing quality of life for millions of people each year. Various studies report complete wound epithelialization of 48 to 56% over 30 to 65 d with different treatment modalities in- cluding ultrasound, topical rPDGF-BB, and composite acellular matrix. This is in contrast to comparison con- trol patients treated with standard wound care, demon- strating complete epithelialization rates of 25 to 39%. Extracorporeal Shock Wave Therapy (ESWT) may accel- erate and improve wound repair. This study assesses the feasibility and safety of ESWT for acute and chronic soft-tissue wounds. Study design. Two hundred and eight patients with complicated, nonhealing, acute and chronic soft-tissue wounds were prospectively enrolled onto this trial be- tween August 2004 and June 2006. Treatment con- sisted of debridement, outpatient ESWT (100 to 1000 Shocks/cm 2 at 0.1 mJ/mm 2 , according to wound size, every 1 to 2 wk over mean three treatments), and moist dressings. Results. Thirty-two (15.4%) patients dropped out of the study following first ESWT and were analyzed on an intent-to-treat basis as incomplete healing. Of 208 patients enrolled, 156 (75%) had 100% wound epitheli- alization. During mean follow-up period of 44 d, there was no treatment-related toxicity, infection, or deteri- oration of any ESWT-treated wound. Intent-to-treat multivariate analysis identified age (P 0.01), wound size <10 cm 2 (P 0.01; OR 0.36; 95% CI, 0.16 to 0.80), and duration < 1m o (P < 0.001; OR 0.25; 95% CI, 0.11 to 0.55) as independent predictors of complete healing. Conclusions. The ESWT strategy is feasible and well tolerated by patients with acute and chronic soft tis- sue wounds. Shock Wave Therapy is being evaluated in a Phase III trial for acute traumatic wounds. © 2007

Wolfgang Schaden - One of the best experts on this subject based on the ideXlab platform.

  • extracorporeal Shock Wave Therapy eswt for wound healing technology mechanisms and clinical efficacy
    Wound Repair and Regeneration, 2012
    Co-Authors: Rainer Mittermayr, Vlado Antonic, Joachim Hartinger, Hanna Kaufmann, Heinz Redl, Luc Teot, Alexander Stojadinovic, Wolfgang Schaden
    Abstract:

    For almost 30 years, extracorporeal Shock Wave Therapy has been clinically implemented as an effective treatment to disintegrate urinary stones. This technology has also emerged as an effective noninvasive treatment modality for several orthopedic and traumatic indications including problematic soft tissue wounds. Delayed/nonhealing or chronic wounds constitute a burden for each patient affected, significantly impairing quality of life. Intensive wound care is required, and this places an enormous burden on society in terms of lost productivity and healthcare costs. Therefore, cost-effective, noninvasive, and efficacious treatments are imperative to achieve both (accelerated and complete) healing of problematic wounds and reduce treatment-related costs. Several experimental and clinical studies show efficacy for extracorporeal Shock Wave Therapy as means to accelerate tissue repair and regeneration in various wounds. However, the biomolecular mechanism by which this treatment modality exerts its therapeutic effects remains unclear. Potential mechanisms, which are discussed herein, include initial neovascularization with ensuing durable and functional angiogenesis. Furthermore, recruitment of mesenchymal stem cells, stimulated cell proliferation and differentiation, and anti-inflammatory and antimicrobial effects as well as suppression of nociception are considered important facets of the biological responses to therapeutic Shock Waves. This review aims to provide an overview of Shock Wave Therapy, its history and development as well as its current place in clinical practice. Recent research advances are discussed emphasizing the role of extracorporeal Shock Wave Therapy in soft tissue wound healing.

  • prospective randomized phase ii trial of accelerated reepithelialization of superficial second degree burn wounds using extracorporeal Shock Wave Therapy
    Annals of Surgery, 2012
    Co-Authors: Christian Ottomann, Richard Thiele, Alexander Stojadinovic, Wolfgang Schaden, Philip T Lavin, Francis H Gannon, Michael H Heggeness, B Hartmann
    Abstract:

    Background:As extracorporeal Shock Wave Therapy (ESWT) can enhance healing of skin graft donor sites, this study focused on Shock Wave effects in burn wounds.Methods:A predefined cohort of 50 patients (6 with incomplete data or lost to follow-up) with acute second-degree burns from a larger study of

  • prospective randomized trial of accelerated re epithelization of skin graft donor sites using extracorporeal Shock Wave Therapy
    Journal of The American College of Surgeons, 2010
    Co-Authors: Christian Ottomann, Richard Thiele, Alexander Stojadinovic, Wolfgang Schaden, B Hartmann, Josh Tyler, Heike Maier
    Abstract:

    Background Extracorporeal Shock Wave Therapy may enhance revascularization and repair of healing soft tissue. Methods Between January 2006, and September 2007, 28 patients with acute traumatic wounds and burns requiring skin grafting were randomly assigned in a 1:1 fashion to receive standard topical Therapy (nonadherent silicone mesh [Mepitel, Molnlycke Health Care] and antiseptic gel [polyhexanide/octenidine]) to graft donor sites with (n = 13) or without (n = 15) defocused extracorporeal Shock Wave Therapy (ESWT, 100 impulses/cm 2 at 0.1 mJ/mm 2 ) applied once to the donor site, immediately after skin harvest. The randomization sequence was computer generated, and the patients were blinded to treatment allocation. The primary endpoint was time to complete donor site epithelialization and was determined by an independent blinded observer. Results Statistical tests indicated no unbalanced distribution of subject characteristics across the two study groups. Mean times to complete graft donor site epithelialization for patients who did and did not undergo ESWT were 13.9 ± 2.0 days and 16.7 ± 2.0 days, respectively (p = 0.0001). Conclusions For centers that apply nonadherent gauze dressings and topical antiseptics to skin graft donor sites, application of a single defocused Shock Wave treatment immediately after skin graft harvest can significantly accelerate donor site epithelialization.

  • Shock Wave Therapy compared with intramedullary screw fixation for nonunion of proximal fifth metatarsal metaphyseal diaphyseal fractures
    Journal of Bone and Joint Surgery American Volume, 2010
    Co-Authors: John P Furia, Wolfgang Schaden, Paul J Juliano, Allison M Wade, Rainer Mittermayr
    Abstract:

    Background:The current “gold standard” for treatment of chronic fracture nonunion in the metaphyseal-diaphyseal region of the fifth metatarsal is intramedullary screw fixation. Complications with this procedure, however, are not uncommon. Shock Wave Therapy can be an effective treatment for fracture

  • Shock Wave Therapy for acute and chronic soft tissue wounds a feasibility study
    Journal of Surgical Research, 2007
    Co-Authors: Wolfgang Schaden, Richard Thiele, Christine Kolpl, Michael Pusch, Aviram Nissan, Christopher E Attinger, Mary E Maniscalcotheberge, George E Peoples, Eric A Elster, Alexander Stojadinovic
    Abstract:

    Background. Nonhealing wounds are a major, func- tionally-limiting medical problem impairing quality of life for millions of people each year. Various studies report complete wound epithelialization of 48 to 56% over 30 to 65 d with different treatment modalities in- cluding ultrasound, topical rPDGF-BB, and composite acellular matrix. This is in contrast to comparison con- trol patients treated with standard wound care, demon- strating complete epithelialization rates of 25 to 39%. Extracorporeal Shock Wave Therapy (ESWT) may accel- erate and improve wound repair. This study assesses the feasibility and safety of ESWT for acute and chronic soft-tissue wounds. Study design. Two hundred and eight patients with complicated, nonhealing, acute and chronic soft-tissue wounds were prospectively enrolled onto this trial be- tween August 2004 and June 2006. Treatment con- sisted of debridement, outpatient ESWT (100 to 1000 Shocks/cm 2 at 0.1 mJ/mm 2 , according to wound size, every 1 to 2 wk over mean three treatments), and moist dressings. Results. Thirty-two (15.4%) patients dropped out of the study following first ESWT and were analyzed on an intent-to-treat basis as incomplete healing. Of 208 patients enrolled, 156 (75%) had 100% wound epitheli- alization. During mean follow-up period of 44 d, there was no treatment-related toxicity, infection, or deteri- oration of any ESWT-treated wound. Intent-to-treat multivariate analysis identified age (P 0.01), wound size <10 cm 2 (P 0.01; OR 0.36; 95% CI, 0.16 to 0.80), and duration < 1m o (P < 0.001; OR 0.25; 95% CI, 0.11 to 0.55) as independent predictors of complete healing. Conclusions. The ESWT strategy is feasible and well tolerated by patients with acute and chronic soft tis- sue wounds. Shock Wave Therapy is being evaluated in a Phase III trial for acute traumatic wounds. © 2007