Shockwave Therapy in Pes Anserinus Tendinopathies: Report of 239 Cases

Shockwave Therapy in Pes Anserinus Tendinopathies: Report of 239 Cases
Rosanna Audain, Alejandra Guevara, Roberto Audain, Yarila Avarez, Nahin Perez

Institution:
Unitrond CA, Venezuela

Device and producing company:
Orthospec, Medispec

Introduction:
The pes anserinus tendinitis is the inflammation of the insertion of the conjoined tendons of three muscles: sartorius, gracilis and semitendinosus.

Methods:
A retrospective study on 309 cases of anterior knee pain was performed between January 2009 and March 2012. Patients with Anterior Knee Pain Syndrome were included in the study: AKPS 239/309 (77.34%), Female 121/239 (50.67%), Male 118/239 (49.37%), mean age: 45 years. Patients were defined as false negative when MRI were not conclusive for tendinopathy, but the patients complained of anterior knee pain in the pes anserinus region. Patients were treated with one session of 3000 focused shockwaves, with an intensity of 0,12- 0,16 mJ/mm2. No sedation was used. We analyzed the variations in the Lysholm score and the pain Visual Analogue Scale at 21 days, 45 days, 3 and six months. Patients were surveyed via telephone to determine the level of satisfaction. Data was studied by analytical and inferential statistical analysis.

Results:
The incidence of AKPS tendinopathies was 70/239 (29.28%). Pes anserinus tendinitis associated with another MRI diagnosis were 49/70 (70%). Patients treated with focused shockwaves were 49/49 (100% ). Level of satisfaction in false negatives: very satisfied 19/49 (38.78%) satisfied 23/49 (46.94 %) dissatisfied 7/49 (14.28%) Lysholm Score: 8(I2n)it.ial 59 - Final

Discussion:
We found a low correlation between clinical diagnosis and Pes Anserinus tendinopathy with MRI findings. These patients trated with ESWT improved the level of satisfaction without complications.

Conclusion:
The best diagnosis of tendinopathy’s pes anserinus is through clinical evaluation and not MRI images. Due the high incidence of false negatives ESWT should be considered as a treatment of choice.