P Rockett, A Souza, P Santos
Ortosom, Porto Alegre; Cortrel, Rio de Janeiro; Orthomaster, São Paulo, Brazil
The aim of this study was to evaluate the efficacy and the safety of extracorporeal shock wave therapy for the treatment of Achilles tendonopathy in three Brazilian Orthopaedics Clinics.
Material and Methods:
In a multi-center, retrospective study, the effect of shockwave therapy was investigated in 73 patients with Achilles tendon calcifying (or not) tendinosys treated in the period of 25 months from May 2002 to May 2004.
There were 28 women and 45 men with an average age of 60 (range, 34-87) years. The criteria for inclusion were at least three months of unsuccessful conservative therapy or six months of pain. Criteria for exclusion were inflammatory arthritis, previous corticosteroid injection, neurological abnormality, gout, malignant diseases, blood coagulation disorders and previous Achilles tendon rupture.
Each patient was treated with 1000 impulses of shock wave, a 05 mm focus depth, and with an energy flux density of no more than 0.13 mi/mm after local anoesthesia.
One treatment was performed on 65 patients, 6 patients underwent a second treatment and 2 patients underwent a third treatment.
The subjects were evaluated by means of a clinical evaluation according to Roles and Maudsley score and subjective outcome on Visual Analogue Scale IAS) analysis 45, 90 and 180 days after the end of the therapy.
The study showed the efficacy and safety of ESWT were excellent in 17.8%, good in 46.6%, acceptable in 21.9%, and poor in 13.7%, 180 days after ESWT.
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