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Long-Term Outcome and Factors Affecting Prognosis of Extracorporeal Shockwave Therapy for Chronic Refractory Achilles Tendinopathy

박영숙|박철현|이유빈|이용택|이정상|서경호|윤경재|이준윤
대한재활의학회 (Korean Academy Of Rehabilitation Medicine)|2017.02|Annals of Rehabilitation Medicine|제41권 제1호|pp. 42-50

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키워드

Treatment outcomePrognosisTendinopathyUltrasonic shockwave
주제분류재활의학

초록

Objective To investigate the factors affecting prognosis of extracorporeal shockwave therapy (ESWT) for chronic refractory Achilles tendinopathy (AT).Methods Thirty-six patients (48 consecutive feet) with chronic AT (>6 months) and who underwent ESWT for ‘poor’ or ‘fair’ grade in Roles-Maudsley Score (RMS) after unsuccessful conservative treatment were included in the present study. A maximum of 12 sessions of ESWT were conducted until treatment success: RMS reached ‘good’ or ‘excellent’. Termination of ESWT for no response, or ‘poor’ or ‘fair’ grade was regarded as treatment failure. Immediate outcome, long-term outcome (telephone interview after mean 26 months), and factors affecting treatment success were analyzed.Results Numeric Rating Scale was significantly decreased at immediate and long-term follow-up. Success rate was 71.1% and 90.3%, respectively. Univariate logistic regression identified that immediate treatment success was associated with retrocalcaneal enthesophyte on X-ray (odds ratio [OR], 0.06; 95% confidence interval [CI], 0.01–0.28), pretreatment abnormal ultrasonography echogenicity within Achilles tendon (OR, 18.89; 95% CI, 2.08–171.96), mean duration of ‘post-treatment soreness’ (OR, 0.55; 95% CI, 0.33–0.94), and duration of ‘post-treatment soreness after first ESWT’ (OR, 0.06; 95% CI, 0.01–0.34). The duration of ‘post-treatment soreness after first ESWT’ was found to be the only factor associated with long-term success (OR, 0.32; 95% CI, 0.10–0.99). Conclusion ESWT appears to be effective in achieving long-term success in chronic refractory AT. Immediate success was associated with absence of retrocalcaneal enthesophyte on X-ray, presence of pretreatment abnormal ultrasonography echogenicity, shorter mean duration of ‘post-treatment soreness’, and shorter duration of ‘post-treatment soreness after first ESWT’. The shorter duration of ‘post-treatment soreness after first ESWT’ was identified as the only positive prognostic parameter in achieving long-term success.

Abstract

Objective To investigate the factors affecting prognosis of extracorporeal shockwave therapy (ESWT) for chronic refractory Achilles tendinopathy (AT).Methods Thirty-six patients (48 consecutive feet) with chronic AT (>6 months) and who underwent ESWT for ‘poor’ or ‘fair’ grade in Roles-Maudsley Score (RMS) after unsuccessful conservative treatment were included in the present study. A maximum of 12 sessions of ESWT were conducted until treatment success: RMS reached ‘good’ or ‘excellent’. Termination of ESWT for no response, or ‘poor’ or ‘fair’ grade was regarded as treatment failure. Immediate outcome, long-term outcome (telephone interview after mean 26 months), and factors affecting treatment success were analyzed.Results Numeric Rating Scale was significantly decreased at immediate and long-term follow-up. Success rate was 71.1% and 90.3%, respectively. Univariate logistic regression identified that immediate treatment success was associated with retrocalcaneal enthesophyte on X-ray (odds ratio [OR], 0.06; 95% confidence interval [CI], 0.01–0.28), pretreatment abnormal ultrasonography echogenicity within Achilles tendon (OR, 18.89; 95% CI, 2.08–171.96), mean duration of ‘post-treatment soreness’ (OR, 0.55; 95% CI, 0.33–0.94), and duration of ‘post-treatment soreness after first ESWT’ (OR, 0.06; 95% CI, 0.01–0.34). The duration of ‘post-treatment soreness after first ESWT’ was found to be the only factor associated with long-term success (OR, 0.32; 95% CI, 0.10–0.99). Conclusion ESWT appears to be effective in achieving long-term success in chronic refractory AT. Immediate success was associated with absence of retrocalcaneal enthesophyte on X-ray, presence of pretreatment abnormal ultrasonography echogenicity, shorter mean duration of ‘post-treatment soreness’, and shorter duration of ‘post-treatment soreness after first ESWT’. The shorter duration of ‘post-treatment soreness after first ESWT’ was identified as the only positive prognostic parameter in achieving long-term success.

참고문헌 (40)

  1. Lake JE, "Conservative treatment of Achilles tendinopathy: emerging techniques", Foot Ankle Clin, 14, pp.663~674 (2009)
  2. Gerdesmeyer L, "Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy", Int J Surg, 24(Pt B), pp.154~159 (2015)
  3. Alfredson H, "Chronic Achilles tendinosis:recommendations for treatment and prevention", Sports Med, 29, pp.135~146 (2000)
  4. Furia JP, "High-energy extracorporeal shock wave therapy as a treatment for insertional Achilles tendinopathy", Am J Sports Med, 34, pp.733~740 (2006)
  5. Den Hartog BD, "Insertional Achilles tendinosis:pathogenesis and treatment", Foot Ankle Clin, 14, pp.639~650 (2009)
  6. Almekinders LC, "Tendinitis and other chronic tendinopathies", J Am Acad Orthop Surg, 6, pp.157~164 (1998)
  7. Lakshmanan P, "Chronic Achilles tendinopathy:treatment with extracorporeal shock waves", Foot Ankle Surg, 10, pp.125~130 (2004)
  8. Taylor J, "Extracorporeal shockwave therapy (ESWT) for refractory Achilles tendinopathy: a prospective audit with 2-year follow up", Foot (Edinb), 26, pp.23~29 (2016)
  9. Rompe JD, "Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis:a randomized controlled trial", Am J Sports Med, 35, pp.374~383 (2007)
  10. Mani-Babu S, "The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review", Am J Sports Med, 43, pp.752~761 (2015)
  11. Al-Abbad H, "The effectiveness of extracorporeal shock wave therapy on chronic achilles tendinopathy: a systematic review", Foot Ankle Int, 34, pp.33~41 (2013)
  12. Bakkegaard M, "Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: a prospective observational study", Eur J Radiol, 84, pp.458~462 (2015)
  13. Van Holsbeeck M, "Musculoskeletal ultrasound" (1991), Mosby
  14. Richards PJ, "Achilles tendon (TA) size and power Doppler ultrasound (PD) changes compared to MRI: a preliminary observational study", Clin Radiol, 56, pp.843~850 (2001)
  15. Kainberger FM, "Injury of the Achilles tendon: diagnosis with sonography", AJR Am J Roentgenol, 155, pp.1031~1036 (1990)
  16. Kallinen M, "Ultrasonographic measurements of the Achilles tendon in elderly athletes and sedentary men", Acta Radiol, 35, pp.560~563 (1994)
  17. Khan KM, "Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study", Br J Sports Med, 37, pp.149~153 (2003)
  18. Koivunen-Niemela T, "Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements", Surg Radiol Anat, 17, pp.263~268 (1995)
  19. Soila K, "High-resolution MR imaging of the asymptomatic Achilles tendon: new observations", AJR Am J Roentgenol, 173, pp.323~328 (1999)
  20. Benjamin M, "The cell and developmental biology of tendons and ligaments", Int Rev Cytol, 196, pp.85~130 (2000)
  21. Benjamin M, "The mechanism of formation of bony spurs (enthesophytes) in the achilles tendon", Arthritis Rheum, 43, pp.576~583 (2000)
  22. Kannus P, "Expression of osteocalcin in the patella of experimentally immobilized and remobilized rats", J Bone Miner Res, 11, pp.79~87 (1996)
  23. Tyrdal S, "Osseous manifestations of ‘handball goalie’s elbow’", Scand J Med Sci Sports, 9, pp.92~97 (1999)
  24. Girolomoni G, "Psoriasis and systemic inflammation : underdiagnosed enthesopathy", J Eur Acad Dermatol Venereol, 23(Suppl 1), pp.3~8 (2009)
  25. Feydy A, "Comparative study of MRI and power Doppler ultrasonography of the heel in patients with spondyloarthritis with and without heel pain and in controls", Ann Rheum Dis, 71, pp.498~503 (2012)
  26. Aydin SZ, "A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes", Rheumatol Int, 36, pp.397~404 (2016)
  27. Genc H, "Ultrasonographic evaluation of tendons and enthesal sites in rheumatoid arthritis: comparison with ankylosing spondylitis and healthy subjects", Clin Rheumatol, 24, pp.272~277 (2005)
  28. Chuckpaiwong B, "Extracorporeal shock wave for chronic proximal plantar fasciitis: 225 patients with results and outcome predictors", J Foot Ankle Surg, 48, pp.148~155 (2009)
  29. Maki M, "Correlation between the outcome of extracorporeal shockwave therapy and pretreatment MRI findings for chronic plantar fasciitis", Mod Rheumatol, 25, pp.427~430 (2015)
  30. Ohberg L, "Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis?", Knee Surg Sports Traumatol Arthrosc, 12, pp.465~470 (2004)
  31. Ohberg L, "Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up", Br J Sports Med, 38, pp.8~11 (2004)
  32. Kulig K, "Achilles and patellar tendon morphology in dancers with and without tendon pain", Med Probl Perform Art, 29, pp.221~228 (2014)
  33. Haake M, "Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow", Arch Orthop Trauma Surg, 122, pp.222~228 (2002)
  34. Peters J, "Extracorporeal shock wave therapy in calcific tendinitis of the shoulder", Skeletal Radiol, 33, pp.712~718 (2004)
  35. Rompe JD, "Dose-related effects of shock waves on rabbit tendo Achillis: a sonographic and histological study", J Bone Joint Surg Br, 80, pp.546~552 (1998)
  36. Rompe JD, "Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy: a randomized, controlled trial", J Bone Joint Surg Am, 90, pp.52~61 (2008)
  37. Furia JP, "High-energy extracorporeal shock wave therapy as a treatment for chronic noninsertional Achilles tendinopathy", Am J Sports Med, 36, pp.502~508 (2008)
  38. Rasmussen S, "Shockwave therapy for chronic Achilles tendinopathy:a double-blind, randomized clinical trial of efficacy", Acta Orthop, 79, pp.249~256 (2008)
  39. Sobhani S, "Epidemiology of ankle and foot overuse injuries in sports: a systematic review", Scand J Med Sci Sports, 23, pp.669~686 (2013)
  40. Filardo G, "Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years", Blood Transfus, 12, pp.533~540 (2014)

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Long-Term Outcome of Low-Energy Extracorporeal Shock Wave Therapy for Plantar Fasciitis: Comparative Analysis According to Ultrasonographic Findings박희진, 이소연, 이용택, Jong-Wan Park, Joon-Youn Lee, Kwang-Soo Chun, Kyungjae Yoon대한재활의학회 · Annals of Rehabilitation Medicine2014 · 제38권 제4호Dose-Related Effect of Extracorporeal Shock Wave Therapy for Plantar Fasciitis강정호, 김자영, 김진홍, 윤서라, 이수진, 정광익대한재활의학회 · Annals of Rehabilitation Medicine2013 · 제37권 제3호아킬레스 건병증의 비수술적 치료정재중대한족부족관절학회 · 대한족부족관절학회지2021 · 제25권 제2호Comparison of Therapeutic Effect of Extracorporeal Shock Wave in Calcific Versus Noncalcific Lateral Epicondylopathy김상준, 박종욱, 최유성, 황지혜대한재활의학회 · Annals of Rehabilitation Medicine2016 · 제40권 제2호3차원 동적집속모드 체외충격파 기기를 이용한 족저근막염 치료의 유용성박재한, 이찬희, 임주애대한족부족관절학회 · 대한족부족관절학회지2022 · 제26권 제2호Comparison of Therapeutic Effect of Extracorporeal Shock Wave in Calcific Versus Noncalcific Lateral Epicondylopathy김상준, 박종욱, 최우성, 황지혜대한재활의학회 · Annals of Rehabilitation Medicine2016 · 제40권 제3호

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