Kertzman Paulo, Lenza Mario, Pedrinelli André, Ejnisman Benno
Departamento de Ortopedia, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Serviço de Ortopedia e Traumatologia, Hospital Israelita Albert Einstein, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Rev Bras Ortop. 2015 Jan 22;50(1):3-8. doi: 10.1016/j.rboe.2015.01.003. eCollection 2015 Jan-Feb.
Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed.
冲击波治疗是骨科领域的一种治疗选择。冲击波治疗肌肉骨骼疾病的确切机制尚不清楚。本研究的目的是对冲击波治疗肌肉骨骼病理状况和假关节患者的有效性进行定性分析。我们在考克兰图书馆、医学文献数据库和拉丁美洲及加勒比地区健康科学数据库中进行了检索。共找到39项报告使用冲击波治疗肌肉骨骼疾病的研究。其结果差异很大，所采用的治疗方案类型也各不相同。评估冲击波治疗外侧上髁炎、肩部肌腱病、膝关节骨关节炎、股骨头坏死和转子滑囊炎有效性的研究，对大多数患者报告的结果并不一致。而评估钙化性肌腱炎、足底筋膜炎、跟腱病、髌腱病和假关节患者的研究则显示出有益效果。对于传统技术效果不佳的慢性病例，冲击波治疗是一种安全且无创的方法，应与其他肌腱病治疗方法联合使用。还需要进一步开展高质量研究。
