The use of extracorporeal shock wave therapy for the treatment of bone marrow oedema — a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research

Jonathan Häußer¹  Philip Catalá-Lehnen¹  Juliane Wieber² 

[1] LANS Medicum Hamburg — Center for Sports and Regenerative Medicine, Stephansplatz 5, 20354, Hamburg, Germany;LANS Medicum Hamburg — Center for Sports and Regenerative Medicine, Stephansplatz 5, 20354, Hamburg, Germany;LANS Medicum Hamburg — Center for Sports and Regenerative Medicine, Hohe Bleichen 24/26, 20354, Hamburg, Germany;

关键词: Bone marrow oedema;    Shock wave therapy;    Conservative therapy;    Non-invasive treatment;    Total hip arthroplasty;    Non-traumatic osteonecrosis;   

DOI  :  10.1186/s13018-021-02484-5

来源: Springer

【 摘 要 】

BackgroundExtracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME.MethodsMEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted.ResultsPain, function, and magnet resonance imaging results all improved across the studies — regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck’s disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = − 2.23, 95% CI − 2.58 to − 1.88, P < 0.0001; after 3–6 month: WMD = − 1.72, 95% CI − 2.52 to − 0.92, P < 0.00001) and function (after 1 month: WMD = − 1.59, 95% CI − 2.04 to − 1.14, P < 0.0001; after 3–6 month: WMD = − 2.06, 95% CI − 3.16 to − 0.96, P = 0.0002; after ≥ 12 month: WMD = − 1.20, 95% CI − 1.83 to − 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group.ConclusionsBased on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME.Trial registrationPROSPERO, CRD42021201719. Registered 23 December 2020

【 授权许可】

CC BY