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Extracorporeal shock wave treatment can normalize painful bone marrow edema in knee osteoarthritis: A comparative historical cohort study.

Abstract Bone marrow edema (BME) represents a reversible but highly painful finding in magnetic resonance imaging (MRI) of patients with knee osteoarthritis. The aim of this retrospective study was to evaluate the efficacy of extracorporeal shock wave treatment (ESWT) on painful BME in osteoarthritis of the knee.This study focuses on people who had early-to-mid stage osteoarthritis with knee pain and MRI findings of BME. Patients who underwent ESWT treatment or prescribed alendronate treatment in our department were analyzed. Knee pain and function were measured using the visual analog scale (VAS) for pain and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), respectively. The degree of BME was measured with MRI scans.A total of 126 patients who received ESWT treatment (Group A, n = 82) or alendronate treatment (Group B, n = 44) were included. All patients were followed up clinically and radiographically for a minimum of 12 months. The mean follow-up was 23.5 months (range, 12-38 months). The VAS and WOMAC score decreased more significantly after treatment in Group A than that in Group B (P <.01) within 3 months. In 6-month MRI follow-ups, there was higher incidence of distinct reduction and complete regression of BME of the affected knee in Group A than that in Group B (P <.01).ESWT is an effective, reliable, and noninvasive treatment in patients with painful BME in osteoarthritis of the knee followed by a rapid normalization of the MRI appearance. It has the potential to shorten the natural course of this disease.
PMID
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Authors

Mayor MeshTerms

Extracorporeal Shockwave Therapy

Keywords
Journal Title medicine
Publication Year Start




PMID- 29384878
OWN - NLM
STAT- MEDLINE
DCOM- 20180209
LR  - 20180209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Extracorporeal shock wave treatment can normalize painful bone marrow edema in
      knee osteoarthritis: A comparative historical cohort study.
PG  - e9796
LID - 10.1097/MD.0000000000009796 [doi]
AB  - Bone marrow edema (BME) represents a reversible but highly painful finding in
      magnetic resonance imaging (MRI) of patients with knee osteoarthritis. The aim of
      this retrospective study was to evaluate the efficacy of extracorporeal shock
      wave treatment (ESWT) on painful BME in osteoarthritis of the knee.This study
      focuses on people who had early-to-mid stage osteoarthritis with knee pain and
      MRI findings of BME. Patients who underwent ESWT treatment or prescribed
      alendronate treatment in our department were analyzed. Knee pain and function
      were measured using the visual analog scale (VAS) for pain and the Western
      Ontario and McMaster University Osteoarthritis Index (WOMAC), respectively. The
      degree of BME was measured with MRI scans.A total of 126 patients who received
      ESWT treatment (Group A, n = 82) or alendronate treatment (Group B, n = 44) were 
      included. All patients were followed up clinically and radiographically for a
      minimum of 12 months. The mean follow-up was 23.5 months (range, 12-38 months).
      The VAS and WOMAC score decreased more significantly after treatment in Group A
      than that in Group B (P &lt;.01) within 3 months. In 6-month MRI follow-ups, there
      was higher incidence of distinct reduction and complete regression of BME of the 
      affected knee in Group A than that in Group B (P &lt;.01).ESWT is an effective,
      reliable, and noninvasive treatment in patients with painful BME in
      osteoarthritis of the knee followed by a rapid normalization of the MRI
      appearance. It has the potential to shorten the natural course of this disease.
FAU - Kang, Shuhua
AU  - Kang S
AD  - Department of Surgery.
FAU - Gao, Fuqiang
AU  - Gao F
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Han, Jun
AU  - Han J
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Mao, Tianli
AU  - Mao T
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Sun, Wei
AU  - Sun W
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Wang, Bailiang
AU  - Wang B
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Guo, Wanshou
AU  - Guo W
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Cheng, Liming
AU  - Cheng L
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
FAU - Li, Zirong
AU  - Li Z
AD  - Department of Orthopedics, China-Japan Friendship Hospital, National Health and
      Family Planning Commission of the People's Republic of China, Peking Union
      Medical College, Beijing, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bone Marrow Diseases/diagnostic imaging/etiology/*therapy
MH  - Edema/diagnostic imaging/etiology/*therapy
MH  - *Extracorporeal Shockwave Therapy
MH  - Female
MH  - Historically Controlled Study
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/*complications/diagnostic imaging/*therapy
MH  - Pain Measurement
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2018/02/01 06:00
MHDA- 2018/02/10 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/10 06:00 [medline]
AID - 10.1097/MD.0000000000009796 [doi]
AID - 00005792-201802020-00040 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9796. doi: 10.1097/MD.0000000000009796.