Treatment of osteochondral lesions of the talus with radial extracorporeal shock wave
LIU Shuitao1, YANG Jun2, SHI Zhan2, ZHANG Haochong2, and XING Gengyan1,2
1.Department of Orthopaedics, Xijing Hospital, the Fourth Military Medical University, Xi’an 710032, China; 2. The First Department of Orthopaedics, the General Hospital of Chinese People’s Armed Police Force, Beijing100039, China
Abstract:Objective To evaluate the effect of the radial extracorporeal shock wave therapy on osteochondral lesions of the talus (OLT).Methods Between January 2010 and June 2016, 54 cases of patients (60 taluses) were treated with radial shock wave. The treatment involved 1.5-2.5 bar, 5 Hz, 2000-3000 shocks every time. Five times were taken as a course of treatment, and a total of three or four courses were needed for a patient. The patients were followed up at three, six, and twelve months after treatment which was evaluated by the patients’ ankle VAS pain score, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score, and the sagittal lesion area by MRI.Results Three months after treatment, the VAS score decreased while the AOFAS score increased, which was significantly different from that before treatment (P<0.05). Six, twelve months after treatment, the ankle pain continued to be eased, and the functional scores continued to improve (P<0.01). The lesion area was (2.67±1.14) cm2 before treatment, but was (1.97±0.77) cm2 three months after treatment, which was reduced obviously at 6 months (1.04±0.61)cm2 and 12 months (0.46±0.25) cm2 (P<0.01), and even completely disappeared in some patients.Conclusions Radial extracorporeal shock wave can achieve good curative effect in the treatment of mild to moderate osteochondral lesions of the talus.
刘水涛, 杨军, 史展, 张浩冲, 邢更彦. 发散式体外冲击波治疗距骨骨软骨损伤的效果[J]. 武警医学, 2017, 28(7): 694-697.
LIU Shuitao, YANG Jun, SHI Zhan, ZHANG Haochong, and XING Gengyan. Treatment of osteochondral lesions of the talus with radial extracorporeal shock wave. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(7): 694-697.
Verhagen RA,Maas M,Dijkgraaf MG. Prospective study on diagnostic strategies in osteochondral lesions of the talus[J].J Bone Joint Surg Br,2005,87(1):41-46.
[6]
Ozal S T,Akca A,Cakmakci E. Is there a relationship between talar osteochondral lesions and foot angles?[J]. Radiol Med, 2016,121(10): 801-804.
[7]
Prado M P,Kennedy J G,Raduan F, et al. Diagnosis and treatment of osteochondral lesions of the ankle: current concepts[J]. Rev Bras Ortop, 2016, 51(5):489-500.
[8]
Elias I,Zoga A C,Morrison W B,et al. Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme[J]. Foot Ankle Int,2007,28( 2) : 154-161.
[9]
Dekker T J,Dekker P K,Tainter D M,et al. Treatment of osteochondral lesions of the talus: acritical analysis review[J]. JBJS Rev, 2017, 5(3):e4.
[10]
Aigner N, Petje G, Steinboeck G, et al. Treatment of bonemarrow oedema of the talus with the prostacyclin analogue iloprost. An MRI-controlled investigation of a new method[J]. J Bone Joint Surg Br, 2001, 83(6):855-858.
[11]
Gao F,Chen N,Sun W,et al. Combined therapy with shock wave and retrograde bone marrow-derived cell transplantation for osteochondral lesions of the talus [J]. Sci Rep,2017, 7(1): 2106.
[12]
Zhao Z,Ji H,Jing R, et al. Extracorporeal shock-wave therapy reduces progression of knee osteoarthritis in rabbits by reducing nitric oxide level and chondrocyte apoptosis[J].Arch Orthop Trauma Surg,2012, 132(11):1547-1553.