van Leeuwen M T, Zwerver J, van den Akker-Scheek I
Center for Sports Medicine, University Center for Sport, Exercise and Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Br J Sports Med. 2009 Mar;43(3):163-8. doi: 10.1136/bjsm.2008.050740. Epub 2008 Aug 21.
Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment; and to identify topics for further research.
A computerised search of the Medline and Embase databases was conducted on 1 August 2007, to identify studies dealing with the effectiveness of ESWT for patellar tendinopathy.
Seven articles describing the effectiveness of ESWT on patellar tendinopathy, all published after 2000, were included. These studies included a total of 283 patients (298 tendons), 204 of whom (215 tendons) were assigned to ESWT treatment. The treatment results were positive but most studies had methodological deficiencies, small numbers and/or short follow-up periods. Method of application and shockwave generation, energy level, number and frequency of treatments, use of (local) anaesthesia and method of localisation were variable.
ESWT seems to be a safe and promising treatment for patellar tendinopathy with a positive effect on pain and function. Based on current knowledge it is impossible to recommend a specific treatment protocol. Further basic and clinical research into the working mechanism and effectiveness of ESWT for patellar tendinopathy are necessary.
体外冲击波疗法(EWST)已成为髌腱病的一种常用治疗方法。本综述的目的是研究体外冲击波疗法(ESWT)治疗髌腱病的有效性;起草ESWT治疗有效方案的指南;并确定进一步研究的主题。
2007年8月1日对Medline和Embase数据库进行了计算机检索,以确定有关ESWT治疗髌腱病有效性的研究。
纳入了7篇描述ESWT对髌腱病有效性的文章,均发表于2000年以后。这些研究共纳入283例患者(298条肌腱),其中204例(215条肌腱)接受ESWT治疗。治疗结果是积极的,但大多数研究存在方法学缺陷、样本量小和/或随访期短的问题。应用方法、冲击波产生方式、能量水平、治疗次数和频率、(局部)麻醉的使用以及定位方法各不相同。
ESWT似乎是一种安全且有前景的髌腱病治疗方法,对疼痛和功能有积极影响。基于目前的知识,无法推荐特定的治疗方案。有必要对ESWT治疗髌腱病的作用机制和有效性进行进一步的基础和临床研究。