ESWT (EXTRACORPOREAL SHOCK WAVE THERAPY)
In the case of an acute injury such as ACL rupture, ESWT is rarely the first line of treatment for the ligament injury itself. The priority is stabilisation or surgery. However, some recent studies show that Extracorporeal Shock Wave Therapy can be used in combination with physical therapy following ACL ligamentoplasty:
Either immediately after surgery (day 2 post-op) Low-power Radial Shockwave Therapy (RSWT) around the patella, plus 10 cm above the patella, thus avoiding the surgical area, at a rate of one session per week for 6 weeks to improve function, pain, and daily activities (Song et al 2024). 6 Or in delayed post-op (6 or 8 weeks post-op): Low-energy RSWT or FSWT on the joint center, femoral tunnel, and tibial tunnel to improve ACLR graft maturation at two-year follow up. 27-28 Another study also showed a faster return to running and pivoting activities, which would be beneficial to skiiers (Weninger et al 2023). 7
Earlier studies demonstrated the effectiveness of ESWT following ligamentoplasty for: • Pain or fibrosis in the Hamstring graft site at the Tendon Bone Insertion (TBI) • On the Patellar tendon, if there is residual tendinopathy following a Bone tendon Bone graft (Savalli et al 2003). 8
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