This is an interesting treatment modality for some orthopaedic conditions. In any case, it is not very popular and there are a lot of controversies with regard to the indications. Some colleagues apply it routinely for treatment of pseudarthrosis of long bones. Some experts recommend it for femoral head osteonecrosis.
Dear Panayot, very interesting question...
Despite the potential of shock wave therapy there are evidence-based indications as pseudarthrosis, tendinosis calcarea of the shoulder joint, chronic radial epicondylitis, plantar fasciitis regarding International Society for Medical Shockwave Treatment.
Avascular necrosis of the femoral head could be a bew clinical application of this technique to be determined in the near future...
http://www.sosshockwave.com/files/2013/06/An-Overview-of-Shock-Wave-Therapy-in-musculoskeletal-disorders.pdf
Thank you, Gustavo, for your answer. The recommendations of International Society for Medical Shockwave Treatment are well recognized. The application of shock wave therapy in cases with early stages of osteonecrosis of the femoral head could be a new indication. The idea is to stimulate the impaired bone metabolism through augmentation of blood delivery, microfracturing or other mechanism (unknown ?). Future studies are needed.
Dear Panayot
I do not have experience with shock wave therapy.
Sufficient data to support extracorporeal shock wave therapy are still lacking. Stem cell therapy seems to be a promising new therapy method
Thank you, Nelson. Stem cell therapy seems to be a promising new method. Unfortunately, there are no convincing evidence-based results so far.
dear dr Panayot
its so interesting for me as an orthopaedic resident to follow this question because of new method in this subject.
Dr. Parsa, I know about the popularity of the method in China and on the Indo-Chinese peninsula. Unfortunately, to my best knowledge by now there are no evidence-based long term results publications.
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