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No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial



The aim of the study was to compare the effectiveness of focused shockwave therapy (FSWT) and radial shockwave therapy (RSWT) for treating patellar tendinopathy.


Patients were randomized into two groups. One group received three sessions of FSWT, and the other group received three sessions of RSWT. Both groups also received an eccentric training programme. Follow-up measurements took place 1, 4, 7 and 14 weeks after the final shockwave treatment. The primary outcome measure was the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire. Secondary outcome measures were pain during ADL, sports activities and the decline squat.


Forty-three subjects (57 tendons) were included in the study. Twenty-one subjects (31 tendons) received FSWT, and 22 subjects (26 tendons) received RSWT. Both groups improved significantly on the VISA-P score, but there were no differences in improvement between the FSWT group (15 points on the VISA-P) and the RSWT group (9.6 points, n.s.). This was also the case for the secondary outcome measures.


There were no statistically significant differences in effectiveness between FSWT and RSWT. It is therefore not possible to recommend one treatment over the other on grounds of outcome. Both groups improved significantly, although it is questionable whether this difference is clinically relevant.

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We would like to thank GymnaUniphy Nederland B.V. for supplying the Storz Duolith SD1. We also thank Mathijs van Ark and Jolanda Boetje for their help with execution of the study, Inge Reininga for performing the randomization and Roy Stewart for his statistical advice. The study was funded by University Medical Center Groningen. The authors declare that they do not have competing interests. GymnaUniphy Nederland B.V. (Berlicum, the Netherlands) supported the TOPSHOCK study by providing the ESWT device. Neither the study nor any of the authors receive or have received any funding or financial compensation from GymnaUniphy. GymnaUniphy has not been involved in the design of the study or in the analysis of the data.

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Correspondence to H. van der Worp.

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van der Worp, H., Zwerver, J., Hamstra, M. et al. No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 22, 2026–2032 (2014).

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  • Patellar tendinopathy
  • ESWT
  • Randomized controlled trial
  • Jumper’s knee