Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons
Purpose: The decision regarding the timepoint of a return to sports after anterior cruciate ligament (ACL) reconstruction is complex and depends on many factors, including objectively tested physical and psychological readiness as well as biological healing. The aim of this study was to investigate...
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| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/10/3350 |
| _version_ | 1797599677745463296 |
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| author | Patrick Weninger Christoph Thallinger Manuel Chytilek Yannis Hanel Caterina Steffel Ramin Karimi Xaver Feichtinger |
| author_facet | Patrick Weninger Christoph Thallinger Manuel Chytilek Yannis Hanel Caterina Steffel Ramin Karimi Xaver Feichtinger |
| author_sort | Patrick Weninger |
| collection | DOAJ |
| description | Purpose: The decision regarding the timepoint of a return to sports after anterior cruciate ligament (ACL) reconstruction is complex and depends on many factors, including objectively tested physical and psychological readiness as well as biological healing. The aim of this study was to investigate the influence of repetitive extracorporeal shockwave therapy (ESWT) on return-to-sports duration, clinical results and MRI results after ACL reconstruction with hamstring tendons (HT). Material and Methods: In this prospective controlled study, all patients with acute ACL ruptures were treated by ACL reconstruction with HT. Patients were randomized into two groups (Group A: ESWT group; Group B: control group). Patients in the ESWT group received focused shockwave therapy 4, 5 and 6 weeks after ACL surgery. Follow-up investigations including IKDC score, Lysholm score, VAS and evaluation regarding return-to-sports timepoints that were conducted 3-, 6-, 9- and 12-months post-operation. An MRI investigation was performed 12-months post-operation and graft maturation (signal intensity ratio (SIR)) as well as femoral and tibial tunnel characteristics (bone marrow oedema, tunnel fluid effusion) were assessed. Results: In total, 65 patients (27.65 ± 7.07 years; 35 male/30 female) were included in this study. The mean timepoint for “return-to-pivoting-sports” was 27.92 weeks (±2.99) in the ESWT group as well as 42.64 weeks (±5.18) in the control group (<i>p</i> < 0.001). In the ESWT group 31 patients (vs. control group: <i>n</i> = 6) attained the “pre-injury activity level”, whereas 6 patients (vs. control group: <i>n</i> = 22) did not reach this level within 12 months post-operation. The IKDC score, Lysholm score, and VAS showed significant improvement in the ESWT group compared with the control group for all time-points (<i>p</i> < 0.001). The mean SIR in the ESWT group revealed 1.81 (±0.88), whereas the control group showed a mean SIR of 2.68 (±1.04) (<i>p</i> < 0.01). Discussion: In conclusion, this is the first study investigating the effect of repetitive ESWT on ACL reconstruction with clinical outcome measurements, including the duration of return-to-sports activity and an MRI follow-up examination. Return-to-sports parameters, clinical scores and graft maturation were significantly improved in the ESWT group. This study may support an earlier return-to-sports timepoint by ESWT and is of high clinical relevance as ESWT is a cost-effective treatment option with no relevant side effects. |
| first_indexed | 2024-03-11T03:37:42Z |
| format | Article |
| id | doaj.art-9b05c83b7719475fa58c5bf3455944d2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:37:42Z |
| publishDate | 2023-05-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9b05c83b7719475fa58c5bf3455944d22023-11-18T01:51:26ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-011210335010.3390/jcm12103350Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring TendonsPatrick Weninger0Christoph Thallinger1Manuel Chytilek2Yannis Hanel3Caterina Steffel4Ramin Karimi5Xaver Feichtinger6Sports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaSports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaSports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaSports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaSports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaDöbling Private Clinic, Heiligenstädter Straße 55-63, 1190 Vienna, AustriaSports Medical Center, Am Hof 11/9, 1010 Vienna, AustriaPurpose: The decision regarding the timepoint of a return to sports after anterior cruciate ligament (ACL) reconstruction is complex and depends on many factors, including objectively tested physical and psychological readiness as well as biological healing. The aim of this study was to investigate the influence of repetitive extracorporeal shockwave therapy (ESWT) on return-to-sports duration, clinical results and MRI results after ACL reconstruction with hamstring tendons (HT). Material and Methods: In this prospective controlled study, all patients with acute ACL ruptures were treated by ACL reconstruction with HT. Patients were randomized into two groups (Group A: ESWT group; Group B: control group). Patients in the ESWT group received focused shockwave therapy 4, 5 and 6 weeks after ACL surgery. Follow-up investigations including IKDC score, Lysholm score, VAS and evaluation regarding return-to-sports timepoints that were conducted 3-, 6-, 9- and 12-months post-operation. An MRI investigation was performed 12-months post-operation and graft maturation (signal intensity ratio (SIR)) as well as femoral and tibial tunnel characteristics (bone marrow oedema, tunnel fluid effusion) were assessed. Results: In total, 65 patients (27.65 ± 7.07 years; 35 male/30 female) were included in this study. The mean timepoint for “return-to-pivoting-sports” was 27.92 weeks (±2.99) in the ESWT group as well as 42.64 weeks (±5.18) in the control group (<i>p</i> < 0.001). In the ESWT group 31 patients (vs. control group: <i>n</i> = 6) attained the “pre-injury activity level”, whereas 6 patients (vs. control group: <i>n</i> = 22) did not reach this level within 12 months post-operation. The IKDC score, Lysholm score, and VAS showed significant improvement in the ESWT group compared with the control group for all time-points (<i>p</i> < 0.001). The mean SIR in the ESWT group revealed 1.81 (±0.88), whereas the control group showed a mean SIR of 2.68 (±1.04) (<i>p</i> < 0.01). Discussion: In conclusion, this is the first study investigating the effect of repetitive ESWT on ACL reconstruction with clinical outcome measurements, including the duration of return-to-sports activity and an MRI follow-up examination. Return-to-sports parameters, clinical scores and graft maturation were significantly improved in the ESWT group. This study may support an earlier return-to-sports timepoint by ESWT and is of high clinical relevance as ESWT is a cost-effective treatment option with no relevant side effects.https://www.mdpi.com/2077-0383/12/10/3350anterior cruciate ligamentextracorporeal shock wave therapygraft maturation |
| spellingShingle | Patrick Weninger Christoph Thallinger Manuel Chytilek Yannis Hanel Caterina Steffel Ramin Karimi Xaver Feichtinger Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons Journal of Clinical Medicine anterior cruciate ligament extracorporeal shock wave therapy graft maturation |
| title | Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons |
| title_full | Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons |
| title_fullStr | Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons |
| title_full_unstemmed | Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons |
| title_short | Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons |
| title_sort | extracorporeal shockwave therapy improves outcome after primary anterior cruciate ligament reconstruction with hamstring tendons |
| topic | anterior cruciate ligament extracorporeal shock wave therapy graft maturation |
| url | https://www.mdpi.com/2077-0383/12/10/3350 |
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