Shockwave therapy effective for knee injury

In the treatment of chronic pain and tenderness around the knee cap, or "patella," shockwave therapy seems to be safer and more effective, with lower recurrence rates, than conventional conservative treatments, suggest the results of a new study.

Conservative treatments are recommended for this chronic overuse syndrome, also referred to as patellar tendinopathy, lead author Dr Ching-Jen Wang said. "However, the recurrent symptoms are high."

Conservative treatment typically includes analgesics, such as ibuprofen or naproxen, along with physical and exercise therapy.

However, based on the current study, "one would consider shockwave as the treatment of choice in athletes with recurrent patellar tendinopathy", Wang said.

Chronic patellar tendinopathy is an overuse syndrome with pathologic changes and tendon injury, similar to tendinopathy of the shoulder, elbow, and heel, Wang, from Chang Gung University College of Medicine, Kaohsiung, Taiwan and colleagues explain in the American Journal of Sports Medicine. Non-invasive extracorporeal (outside the body) shockwave therapy has shown to be effective for many tendinopathies.

Sessions

In a group of individuals with chronic patellar tendinopathy, Wang's team compared the efficacy of 1,500 impulses of extracorporeal shockwave at 14 KV to the affected knee in a single session with that of conservative management consisting of nonsteroidal anti-inflammatory drugs, physiotherapy, exercise and a knee strap.

They randomly assigned 27 patients (30 knees) to shockwave therapy and 23 patients (24 knees) to the conservative management group (controls).

After 2 to 3 years of follow-up, overall results were significantly better in the shockwave group than in the conservative management group. In the shockwave group, outcomes were deemed "excellent" in 43 per cent of patients, "good" in 47 per cent, "fair" in 10 per cent and "poor" in none. In the conservative group, none had excellent outcomes.