The Efficacy of Large-Focused and Controlled-Unfocused (Radial) Extracorporeal Shock Wave Therapies in the treatment of Patellar Tendinopathy: A randomized sham-controlled single-blind trial

The Efficacy Extracorporeal Shock Wave Therapies in the treatment of Patellar Tendinopathy

Abstract

Objectives: Although Extracorporeal Shock Wave Therapy (ESWT) is a widely used treatment option in patellar tendinopathy (PT), treatment protocols are not clearly defined. There is no consensus on the type of shock wave or the energy level, number of shocks, pressure, and frequency values. For this reason, this study will, on the one hand, aim to contribute to the confusion of whether ESWT is effective in the treatment of PT and, on the other hand, try to define the most effective ESWT protocol in the treatment of PT, rather than choosing one at random.

Methods: Seventy eight patients with PT randomised to ‘Controlled Unfocused/Radial’ ESWT (r-ESWT), ‘Large-Focused’ ESWT (f-ESWT) and sham ESWT (s-ESWT) groups. The patients received the ESWT application once a week for a total of three sessions. Patients were evaluated with Visual Analog Scale (VAS) and Victorian Institute of Sports Assessment-Patella (VISA-P) scores just before the treatment (baseline), one day after the end of treatment (week 3), one month after the end of treatment (week 7) and three months after the end of treatment (week 15).

Results: VAS and VISA-P scores have significantly improved at 3^th, 7^th, and 15^th weeks in the r-ESWT group (p<0.05) and at 7^th, and 15^th weeks in the f-ESWT group (p<0.05). In terms of baseline-3^th week, baseline-7^th week and baseline-15^th week differences of VAS and VISA-P scores, r-ESWT was superior to f-ESWT (p<0.05).

Conclusions: Although both r-ESWT and f-ESWT were effective in the treatment of PT according to the results of this study, the efficacy of r-ESWT was superior to f-ESWT.

Key Words: patellar tendinopathy, extracorporeal shock wave therapy, radial, focused