Current concepts of shockwave therapy in stress fractures

Stress fractures are common painful conditions in athletes, usually associated to biomechanical overloads. Low risk stress fractures usually respond well to conservative treatments, but up to one third of the athletes may not respond, and evolve into high-risk stress fractures. Surgical stabilizatio...

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Autores:
Leal, Carlos
D'Agostino, Cristina
Gomez Garcia, Santiago
Fernandez, Arnold
Tipo de recurso:
Article of journal
Fecha de publicación:
2015
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/3718
Acceso en línea:
http://hdl.handle.net/20.500.12495/3718
https://doi.org/10.1016/j.ijsu.2015.07.723
https://repositorio.unbosque.edu.co
Palabra clave:
Shockwave therapy
Stress fractures
Bone turnover
Bone overuse
Mechanotransduction
Rights
openAccess
License
Acceso abierto
Description
Summary:Stress fractures are common painful conditions in athletes, usually associated to biomechanical overloads. Low risk stress fractures usually respond well to conservative treatments, but up to one third of the athletes may not respond, and evolve into high-risk stress fractures. Surgical stabilization may be the final treatment, but it is a highly invasive procedure with known complications. Shockwave treatments (ESWT), based upon the stimulation of bone turnover, osteoblast stimulation and neovascularization by mechanotransduction, have been successfully used to treat delayed unions and avascular necrosis. Since 1999 it has also been proposed in the treatment of stress fractures with excellent results and no complications. We have used focused shockwave treatments in professional athletes and military personnel with a high rate of recovery, return to competition and pain control. We present the current concepts of shockwave treatments for stress fractures, and recommend it as the primary standard of care in low risk patients with poor response to conventional treatments.