Wirksamkeit der Extrakorporalen Stoßwellentherapie in der Behandlung der konservativ therapieresistenten Fasziitis plantaris. -Eine prospektive, randomisierte, kontrollierte, einfach blinde Multicenterstudie

Gabriele Nolte, Gabriele Nolte, Orthop
2011
Symptomatic heel spur is a common orthopedical syndrome. In only few cases it needs differential diagnosis by imaging methods. The aim of therapy is to treat the symptom, not the spur. In the beginning conservative therapy modalities (including corticoid injections) should be applied. Due to risks the release of the fascia surgery is chosen as ultima ratio. ESWT should be applied if conservative treatment fails before surgery is performed. ESWT developed from ESWL in 1991 to treat
more » ... . During the years positive effects in treatment of calcaneous tendinitis, lateral epicondylopathy and heel spur were seen. The treatment?s of insertional tendinopathies was hyperstimulation (Melzak). Soft tissue calcifications and bony non unions were treated with the idea of mechanical alterations. According to basic research of the early 2000th neurotransmitter release induced by ESWT is thought to have major effects in all indications. Shock wave application causes tissue damage. In clinical application only minor and reversible side effects could be detected. In 1995 first results of ESWT in plantar fasciitis were published followed by the first RCT in 1996. The Marburger multicenter trial was planned in 1997 to show safety and effectiveness of ESWT according to the criteria of EBM. Main criteria (Roles and Maudsley Score) and side criteria (VAS pain scale and walking distance) were investigated before treatment, at 6 weeks, 3 and 12 months follow up. In addition MRT investigation was performed before and at 3 month follow up. Analgetics consumption was checked through the follow up period. This study presents the results of the Orthopaedic Clinic of Kassel and discusses them in context of latest developments. The check of drop outs and blindings showed satisfactory results. The randomisation was unsatisfactory when it comes to pain intensity and duration of symptoms. Although the consumption of [...]
doi:10.17192/z2004.0005 fatcat:sncabbc7eff7zmi5qe4gw33diy