Department of Orthopaedic Surgery at Jeroen Bosch General Hospital, Henri Dunantstraat 1, 's-Hertogenbosch, 5223 GZ, The Netherlands.
Department of Orthopaedic Surgery at Máxima Medical Centre, The Netherlands.
Int J Surg. 2017 Oct;46:133-145. doi: 10.1016/j.ijsu.2017.08.587. Epub 2017 Sep 7.
Extracorporeal shockwave therapy (ESWT) seems to be an effective treatment for plantar fasciitis (PF) and is assumed to be safe. No systematic reviews have been published that specifically studied the complications and side effects of ESWT in treating PF. Aim of this systematic review is therefore to evaluate the complications and side effects of ESWT in order to determine whether ESWT is a safe treatment for PF.
For this systematic review the databases PubMed, MEDLINE, Cochrane and Embase were used to search for relevant literature between 1 January 2005 and 1 January 2017. PRISMA guidelines were followed.
Thirty-nine studies were included for this review, representing 2493 patients (2697 heels) who received between 6424 and 6497 ESWT treatment sessions, with an energy flux density between 0.01 mJ/mm and 0.64 mJ/mm and a frequency of 1000-3800 SWs. Average follow-up was 14.7 months (range: 24 h - 6 years). Two complications occurred: precordial pain and a superficial skin infection after regional anaesthesia. Accordingly, 225 patients reported pain during treatment and 247 reported transient red skin after treatment. Transient pain after treatment, dysesthesia, swelling, ecchymosis and/or petechiae, severe headache, bruising and a throbbing sensation were also reported.
ESWT is likely a safe treatment for PF. No complications are expected at one-year follow-up. However, according to the current literature long-term complications are unknown. Better descriptions of treatment protocols, patient characteristics and registration of complications and side effects, especially pain during treatment, are recommended.
体外冲击波疗法（ESWT）似乎是治疗足底筋膜炎（PF）的有效方法，且被认为是安全的。目前尚未发表专门研究 ESWT 治疗 PF 的并发症和副作用的系统评价。因此，本系统评价的目的是评估 ESWT 的并发症和副作用，以确定 ESWT 是否是治疗 PF 的安全方法。
本系统评价检索了 2005 年 1 月 1 日至 2017 年 1 月 1 日期间的 PubMed、MEDLINE、Cochrane 和 Embase 数据库，以寻找相关文献。本研究遵循 PRISMA 指南。
本研究共纳入 39 项研究，共 2493 例患者（2697 只足跟）接受了 6424 至 6497 次 ESWT 治疗，能量通量密度为 0.01 mJ/mm 至 0.64 mJ/mm，频率为 1000 至 3800 次/秒。平均随访时间为 14.7 个月（范围：24 小时至 6 年）。共发生 2 种并发症：心前区疼痛和区域麻醉后浅表皮肤感染。因此，225 例患者在治疗过程中报告疼痛，247 例患者在治疗后报告短暂的皮肤发红。治疗后短暂疼痛、感觉异常、肿胀、瘀斑和/或瘀点、严重头痛、瘀伤和悸动感也有报道。
ESWT 可能是治疗 PF 的一种安全方法。在一年的随访中预计不会出现并发症。然而，根据目前的文献，长期并发症尚不清楚。建议更好地描述治疗方案、患者特征以及并发症和副作用的登记，特别是治疗过程中的疼痛。
