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. 2016 Oct;40(5):871-877.
doi: 10.5535/arm.2016.40.5.871. Epub 2016 Oct 31.

Effectiveness of Lower Energy Density Extracorporeal Shock Wave Therapy in the Early Stage of Avascular Necrosis of the Femoral Head

Yong Han  1 , June-Kyung Lee  1 , Bong-Yeon Lee  1 , Hoi-Sung Kee  1 , Kwang-Ik Jung  1 , Seo-Ra Yoon  1
Affiliations

Effectiveness of Lower Energy Density Extracorporeal Shock Wave Therapy in the Early Stage of Avascular Necrosis of the Femoral Head

Yong Han et al. Ann Rehabil Med. 2016 Oct.

Erratum in

Abstract

Objective: To evaluate the effectiveness of lower energy flux density (EFD) extracorporeal shock wave therapy (ESWT) in the early stage of avascular necrosis (AVN) of the femoral head.

Methods: Nineteen patients and 30 hips were enrolled. All subjects received 4 weekly sessions of ESWT, at different energy levels; group A (n=15; 1,000 shocks/session, EFD per shock 0.12 mJ/mm2) and group B (n=15; 1,000 shocks/session, EFD per shock 0.32 mJ/mm2). We measured pain by using the visual analog scale (VAS), and disability by using the Harris hip score, Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). To determine the effect of the lower EFD ESWT, we assessed the VAS, Harris hip score, HOOS, WOMAC of the subjects before and at 1, 3, and 6 months.

Results: In both groups, the VAS, Harris hip score, HOOS, and WOMAC scores improved over time (p<0.05).

Conclusion: Lower EFD ESWT may be an effective method to improve the function and to relieve pain in the early stage of AVN.

Keywords: Disability evaluation; Femoral head necrosis; High-energy shock waves; Treatment outcome.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. A flow diagram, showing the treatment process and assessment. ESWT, extracorporeal shock wave therapy; EFD, energy flux density.
Fig. 2
Fig. 2. The visual analogue scale (VAS) score at baseline and at 1-, 3-, and 6-month follow-ups after extracorporeal shock wave therapy in both groups. This figure shows significant improvement in the VAS score in both groups, for the entire period (*p<0.05 for time effect, *p<0.05 for group-time interaction). Group A, 0.12 mJ/mm2 energy group; group B, 0.32 mJ/mm2 energy group.
Fig. 3
Fig. 3. The Harris hip (HH) score at baseline and at 1-, 3-, and 6-month follow-ups after extracorporeal shock wave therapy in both groups. This figure shows significant improvement in the HH score in both groups, for the entire period (*p<0.05 for time effect, *p<0.05 for group-time interaction). Group A, 0.12 mJ/mm2 energy group; group B, 0.32 mJ/mm2 energy group.
Fig. 4
Fig. 4. The Hip dysfunction and Osteoarthritis Outcome Score (HOOS) score at baseline and at 1-, 3-, and 6-month follow-ups after extracorporeal shock wave therapy in both groups. This figure shows significant improvement in the HOOS score in both groups, for entire period (*p<0.05 for time effect, *p<0.05 for group-time interaction). Group A, 0.12 mJ/mm2 energy group; group B, 0.32 mJ/mm2 energy group.
Fig. 5
Fig. 5. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score at baseline and at 1-, 3-, and 6-month follow-ups after extracorporeal shock wave therapy in both groups. This figure shows significant improvement in the WOMAC score in both groups, for entire period (*p<0.05 for time effect, *p<0.05 for group-time interaction). Group A, 0.12 mJ/mm2 energy group; group B, 0.32 mJ/mm2 energy group.
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