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Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis

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Abstract

Purpose

Extracorporeal shockwave therapy (ESWT) has become a common practice for treating knee osteoarthritis (OA). However, the effectiveness and safety of this treatment are still questionable. This meta-analysis is aimed at determining the degree of pain reduction and functional outcome after ESWT for knee OA.

Methods

We systematically searched MEDLINE, EMBASE, and other online databases. The articles comparing the outcomes between ESWT and controls were included in the analysis.

Results

Nine studies with 705 patients were included. The pooled data revealed significantly lower pain scores in the ESWT groups than in the control groups within two weeks of treatment and six months after treatment (visual analogue scale, − 1.59, p = 0.0003, 95% confidence interval (CI) − 2.45 to − 0.72 at 2 weeks; − 1.12, p = 0.005, 95% CI − 1.89 to − 0.34 at 6 months). The ESWT group also had better functional outcomes four to six weeks post treatment (Western Ontario and McMaster Universities Osteoarthritis Index, − 11.96, p = 0.003, 95% CI − 19.76 to − 4.15). No rebound pain was noted for up to 12 months.

Conclusion

Using ESWT to treat knee OA may reduce pain and improve functional outcomes. The effect may last six months to one year. More prospective studies are needed to investigate the settings for ESWT to optimize treatment results.

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Chi-Kun Hsieh, Zhao-Wei Liu, Chao-Jui Chang, and Ta-Wei Tai. The first draft of the manuscript was written by Chi-Kun Hsieh, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan

    Chi-Kun Hsieh, Chao-Jui Chang & Ta-Wei Tai

  2. Physical Therapy Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Zhao-Wei Liu

  3. Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Ta-Wei Tai

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  1. Chi-Kun Hsieh
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Correspondence to Ta-Wei Tai.

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Hsieh, CK., Chang, CJ., Liu, ZW. et al. Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis. International Orthopaedics (SICOT) 44, 877–884 (2020). https://doi.org/10.1007/s00264-020-04489-x

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