The therapeutic use of ESWT in orthopaedics
The therapeutic use of ESWT in orthopaedics was introduced in Germany, and it has been in a full swing for the last 10. A special device (lithotripter) produces shock waves outside the body, which affect the diseased tissue at the cellular and extracellular level. The membrane permeability is enhanced, the inhibition of pain receptors is triggered, proliferation of blood vessels is stimulated, and it has many other effects that promote biological treatment of the diseased tissues. Although initially the main purpose of this therapeutic method was the treatment of fractures and poor bone overgrowth, recently, it has been most commonly used in the treatment of localized musculoskeletal problems such as tendinopathy, fasciitis, stress syndrome and other entesiopathies in the elbow, knee and foot. The most frequent localizations are at the shoulder joint.
Basic information about the examination
ESWT is used in orthopaedic patients in whom conventional physiotherapy was not successful and the surgery is not absolutely indicated. According to data from the literature, the success of this method with properly chosen indication is 50-80%. Some use the ESWL method for the treatment of pseudoarthrosis.
For the treatment with ESWT, a device for calcium deposit pulverization is required (lithotripter), which can produce shock waves of different strengths, which affect the diseased tissue. Shock waves also enable crushing or fragmentation of the calcium deposits in the skeletal-muscular system, which allows for a faster resorption of calcium deposits, and earlier recovery of patients.
This method is most useful in calcinations in the area of the shoulder joint, so the patients with such diagnosis can be, in a very high percentage, treated without surgery. In these patients we try to avoid hospitalization and surgery treatment. Their treatment is performed in an outpatient setting.
At Diagnostic Centre in Bled we are the only ones in Slovenia to have the device for shattering calcinations (lithotripter) at our disposal. The procedure is performed as self-pay. We observe that this method produces good and promising clinical results. In addition, it is an non-invasive method, with few complications, the treatment is performed in outpatient setting, and most importantly of all, many patients are spared with a less pleasant way of treatment.