Effect of Extracorporeal Shockwave Therapy on Variable Foot & Ankle Musculoskelectal Diseases

Effect of Extracorporeal Shockwave Therapy on Variable Foot & Ankle Musculoskelectal Diseases
Kiwon Young, Hunki Cho

Institution:
Eulji Hospital Foot & Ankle Clinic, Seoul, Korea

Device and producing company:
PiezoWave, WOLF

Introduction:
ESWT is widely used in Orthopaedic Foot and Ankle Musculoskelectal disease. Most commonly applied disease is plantar fasciitis. However, many other disease can be applied for treatment between conservative and surgical treatment. We applied ESWT on variable foot and ankle disease, that failed to treat conservative method and before surgical treatment. Here we analyze variable disease and their effect of ESWT in foot and ankle musculoskelectal fields.

Methods:
Variable foot and ankle disease that is not effective in conservative treatement were treated ESWT. The diseases are plantar fasciitis, post op persistant pain(Excision of accessory navicular, Anke instability with modified Brostrom procedure), acute and chronic ankle sprain, pain at previous fracture site, bursitis, osteoarthritis and chondral lesion, Morton's neuroma, contusion, and achilles tendinitis.
Retrospective analysis of prospectively collected clinical data of patients treated with ESWT. 201 patients' data (Male: 69 , Female: 134) were collected satisfaction that graded by 4 (Exellent-Good-Fair-Poor) at before and 2 weeks after the last treatment. We defined the term 'Excellent' as pain relieved much better than before and the term "Good" as pain relieved better than before, but not as much as "Excellent". "Fair" for on change in pain, "Poor" defined as pain get worse than before. All the patient were failed to other conservative treatment and before treatment of ESWT, satisfaction were F or P state.

Results:
The percentage of patients for (1)Plantar fasciitis group was 58.7% of all patients and the results is 28% for Excellent, 50% for Good, 20% for Fair, 2% for Poor. (2)Post operative perisistent pain was 8.9% of all patients and the results is 28% for Excellent, 50% for Good, 20% for Fair, 2% for Poor. (3)Acute and chornic ankle sprain / Inflammtory disease such as tenosynovitis was 8.9% of all patients and its clinical outcome was 22% for Excellent, 67% for Good, 11% for Fair, 0% for Poor. (4)Pain at previous fracture site that was treated by conservative method was 2.9% of all patients and its clinical outcome was 33% for Excellent, 67% for Good, 0% for Fair, 0% for Poor. (5)Bursitis was 2.9% of all patients and its clinical outcome was 0% for Excellent, 83% for Good, 17% for Fair, 0% for Poor. (6)Osteoarthitis and chondral lesion was 3.4% of all patients and 0%, 29%, 57%, 14%. (7)Morton’s neurmoa was 5.9% of all patients and 16%, 16%, 68%, 0%. (8)Contusion was 0.9% of all patients and 50%, 50%, 0%, 0%. (9)Achilles tendinitis was 6.9% of all patients and 0%, 71%, 29%, 0% for Excellent, Good, Fair, Poor each. We defined "Effectiveness of ESWT" when more than half of patient get better (that feel Excellent or good). The disease being effective is Bursitis, both acute and chronic ankle sprain, tenosynovitis, plantar fascia, Achilles tendinitis, fracture that didn't need to operate, and contusion. ESWT did not bring a satisfactory effect on Morton's neuroma. No serious complications were observed.

Discussion:
no

Conclusion:
The ESWT can be applied variable foot and ankle disease as well as plantar fasciitis. The effect of ESWT on variable foot and ankle disease is around 70% and good result especially painful post op or after fracture status.