Applications in Musculoskeletal Disorders - part 1 doc

Associate Professor Department of Orthopedics Johannes Gutenberg University School of Medicine Mainz, Germany 82 illustrations 17 tables Thieme Stuttgart · New York... Nevertheless this

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Shock Wave Applications

in Musculoskeletal Disorders

Jan-Dirk Rompe, M.D.

Associate Professor

Department of Orthopedics

Johannes Gutenberg University

School of Medicine

Mainz, Germany

82 illustrations

17 tables

Thieme

Stuttgart · New York

Library of Congress Cataloging-in-Publication Data is

available from the publisher

Any reference to or mention of manufacturers or

specific brand names should not be interpreted as

an endorsement or advertisement for any company

or product.

Some of the product names, patents, and

regis-tered designs referred to in this book are in fact

reg-istered trademarks or proprietary names even

though specific reference to this fact is not always

made in the text Therefore, the appearance of a

name without designation as proprietary is not to be

construed as a representation by the publisher that

it is in the public domain.

This book, including all parts thereof, is legally

protected by copyright Any use, exploitation, or

commercialization outside the narrow limits set by

copyright legislation, without the publisher’s

con-sent, is illegal and liable to prosecution This applies

in particular to photostat reproduction, copying,

preparation of microfilms, and electronic data

pro-cessing and storage.

Important Note: Medicine is an ever-changing

sci-ence undergoing continual development Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and pub-lishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book Nevertheless this does not involve, imply, or express any guarantee or responsibility on the part

of the publishers in respect of any dosage instruc-tions and forms of application stated in the book Every user is requested to examine carefully the manufacturers’ leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage sched-ules mentioned therein or the contraindications stated by the manufacturers differ from the state-ments made in the present book Such examination

is particularly important with drugs that are either rarely used or have been newly released on the mar-ket Every dosage schedule or every form of applica-tion used is entirely at the user’s own risk and responsibility The authors and publishers request every user to report to the publishers any discrepan-cies or inaccuradiscrepan-cies noticed.

Cover drawing by Martina Berge, Erbach

© 2002 Georg Thieme Verlag, Rüdigerstraße 14, D-70469 Stuttgart, Germany

Thieme, 333 Seventh Avenue, New York, NY 10001, USA.

Typesetting by Mitterweger & Partner, Plankstadt

Printed in Germany by Gulde Druck, Tübingen

ISBN 3-13-130121-X (GTV) ISBN 1-58890-079-7 (TNY) 1 2 3 4 5

My father, Professor Gerhard Rompe,

on the occasion of his 70th birthday.

He has stimulated my orthopedic and scientific thinking for decades.

To

M y orthopedic mentors at the Johannes Gutenberg University School of Medicine, and particularly

to Professor Jochen Heine who introduced me to the intriguing world of orthopedic shock wave therapy.

My present colleagues at the

Department of Orthopedics who have generously referred to me interesting shoulder, elbow, and heel problems throughout the years All orthopedic surgeons throughout the world who have shared their interesting cases with me, so that some strides might be made in the diagnosis and non-invasive

treatment of these often neglected patients.

My colleague and friend, Lowell Weil Sr who encouraged me to write down our experiences in English and share them with

physicans in Anglo-American

countries.

And my wife and our children who understand and support me in my endeavors.

Foreword

For more than 20 years extracorporeal shock

wave lithotripsy has been the standard tool

for dealing with calculi in the kidney and in

the ureter Today, surgical therapy plays only a

minor role in the treatment of this disease

About a decade ago, extracorporeal shock

wave application (ESWA) was transferred

from urology to other medical fields,

includ-ing gastroenterology and orthopedics

The aim of this book is to assess, from a

sci-entific point of view, past efforts in

experi-mental research and clinical application of

shock waves related to chronic

musculoskele-tal disorders, and to point out future fields of

interest

Only recently have prospective randomized

studies been released concerning effective

treatment protocols for patients suffering

from chronic painful heel, tennis elbow, and

calcifying tendinitis of the shoulder The

author presents his own extraordinary

experi-ence, discussing the advantages and disadvan-tages of various concepts, thus giving the reader extensive information about possibili-ties and limitations of shock wave application (SWA) presently available

The animal experiments presented in this book clearly demonstrate the possible damag-ing effects of shock waves on tendons and on peripheral nerves and point out to the reader the close relationship between physical parameters and tissue reaction

I consider it important that the author addresses problems related to SWA for mus-culoskeletal disorders, while simultaneously pointing to the beneficial effects of this new, noninvasive procedure

This book will form the scientific basis for restrictive indications, for medical quality assessment, and for familiarizing doctors with

an innovative treatment concept

Mainz, December 2001 Prof Jochen Heine, MD

Director Department of Orthopedics Johannes Gutenberg University School of Medicine

Mainz, Germany

VII Preface

Plantar fasciitis is one of the most common

conditions presenting to foot and ankle

spe-cialists Although the condition is usually

responsive to conservative and nonoperative

care, recalcitrant plantar fasciitis occurs in

10–20 % of the patients treated

Until recently, plantar fasciotomy, with or

without spur resection or release of nerve

entrapments, has been the only option for this

ever-increasing patient population

For 6 years we have patiently awaited the

opportunity to evaluate this newmodality of

extracorporeal shock wave therapy (ESWT)

As one would expect, skepticism and cynicism

prevailed until our first 10 patients rendered

favorable responses within days of treatment

Lowell Weil, Jr., one of my associates,

embraced this technology and we traveled to

Naples, Italy, in June of 2000 to attend the 2nd

International Meeting of the International

Musculoskeletal Shock Wave Association We were thoroughly impressed with the honesty and attempt at providing results according to evidence-based medicine

Upon meeting Jan Rompe, we found an indi-vidual who was energetic, bright, and honest With the recent application and ongoing clinical trials of ESWT occurring in the United States, I encouraged Dr Rompe to write a book

in English as a work of reference for those of

us who are monolingual

As an author of more than 12 papers on ESWT, Jan Rompe was able to write this text, which is a combination of a current literature reviewand the results of clinical trials at his medical institution, on virtually every appli-cation of musculoskeletal ESWT With more than 200 relevant references, this book will be

a “must read” for those wishing to learn more and apply this exciting and newtechnology Chicago, December 2001 Lowell Scott Weil, Sr., DPM

Editor-in-Chief Weil Foot & Ankle Institute Des Plaines, IL, USA

Acknowledgments

A heartfelt thank-you to Lowell Weil Sr for

giving me the courage to write a book in a

for-eign language, for reviewing this work, and

for his invaluable help in handling many

details with Thieme Publishers

It is with grateful appreciation that I

acknowledge the skill and dedication of Erwin

Scholtz and Barbara Hof-Barocke in rendering

the medical illustrations They gave the art for

this book high priority, and Iam appreciative

of their devotion to this work

A note of appreciation is also given to Dr Clifford Bergman who served as an invaluable interface with Thieme Publishers in taking care of numerous details that led to the com-pletion of this book In the shortest time pos-sible he initiated publication of this work