Extracorporal shock wave therapy for the treatment of arthrodesis non-unions

• Published in: Archives of orthopaedic and trauma surgery 2020-09, Vol.140 (9), p.1191-1200
• Main Authors: Everding, Jens, Stolberg-Stolberg, Josef, Pützler, Jan, Roßlenbroich, Steffen, Ochman, Sabine, Raschke, Michael
• Format: Article
• Language: English
• Subjects: Ankle; Arthrodesis - adverse effects; Bone surgery; Extracorporeal Shockwave Therapy; Foot Joints - physiopathology; Foot Joints - surgery; Hand Joints - physiopathology; Hand Joints - surgery; Humans; Lithotripsy; Medicine; Medicine & Public Health; Orthopedics; Pain; Postoperative Complications - physiopathology; Postoperative Complications - therapy; Retrospective Studies; Trauma Surgery; Treatment Outcome
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-020-03361-2

Introduction Non-union is a regular complication of arthrodeses. Standard treatment includes revision surgery with frequent need for re-revision due to persistent non-union. Particularly patients with concomitant diseases are at risk of secondary complications. There is a need for evaluation of alternative treatment options. The aim of this study is to provide first evidence on union-rate and pain course after focussed extracorporeal shock-wave therapy of arthrodesis non-unions. Patients and methods In a retrospective single-centre study, 25 patients with non-union following arthrodesis received one session of focussed extracorporeal shock-wave therapy (energy flux density 0.36 mJ/mm 2 , 3000 impulses, 23 kV, 4 Hz). Radiographic and clinical results were recorded 6, 12 and 24 weeks after treatment. Results 24 patients were followed-up. After 24 weeks arthrodeses of the hand healed in 80%, of the upper ankle in 50%, of subtalar joint in 27.2% and of the midfoot in 0% of the cases. Pain decreased from 4.8 (± 2.8) points on the visual analogue scale to 3.4 (± 2.3), 2.9 (± 2.5) and 2.4 (± 2.8) points after 6, 12 and 24 weeks, respectively ( p