[Complications, side-effects and contraindications in the use of medium and high-energy extracorporeal shock waves in orthopedics]

Abstract

Introduction: Possible complications and side effects using extracorporeal shock waves for orthopaedic diseases should be evaluated.

Method: Since 1993 we prospectively evaluated the complications and adverse effects applying extracorporeal shockwaves for orthopaedic diseases. Within three years 542 lithotripsies in 276 patients were made. 190 patients were treated because of calcifying tendinitis, 34 for epicondylitis and 52 suffering from a plantar heel spur.

Results: In 216 cases we could recognize small superficial hematomas, 4 hyperventilations and in 3 cases a blood pressure elevation over 200 mmHg. Two cases of high blood pressure showed data over 200 mmHg without other clinical symptoms. They were of transitory nature during therapy. In one case we had to treat a hypertension crisis within the first 3 hours after therapy. Today the application of shockwaves in the thoracic region or lung, coagulopathies or anticoagulant medicine, pregnancy and the use at nerval or vascular structures represent an absolute contraindication. When using extracorporeal shock waves for bone lithotripsy, bone tumors, bone infection or infected pseudarthrosis and the application at growth plates in children and young adults represent an absolute contraindication.

Conclusion: In general lithotripsy has only minor complications when it is used accurate.