Focused Shockwave Treatment for Greater Trochanteric Pain Syndrome: A Multicenter, Randomized, Controlled Clinical Trial
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(7):8 J Bone Joint Surg Am. 2020 Aug 5;102(15): 1305-1311.What this means for my practice?
Findings from this randomized controlled trial may suggest that electromagnetic-focused extracorporeal shockwave treatment combined with an exercise protocol can help improve pain, hip and lower extremity function, quality of life, and satisfaction in patients with greater trochanteric pain syndrome in the short term and up to 6-months post-intervention. Yet, limitations of this study included the short term follow-up of 6 months and a small sample size. Furthermore, the placebo group still consisted of electromagnetic-focused extracorporeal shockwave treatment at a very low frequency, and a control group is needed including no treatment at all. Therefore, larger randomized controlled trials including long-term follow-up of at least 1 year with a true control group are needed to help confirm this study's findings.
Study Summary
One hundred and three patients with unilateral chronic greater trochanteric pain syndrome (GTPS) were randomized to receive electromagnetic focused extracorporeal shockwave treatment (F-ESWT) with a specific exercise protocol or sham F-ESWT with the same exercise protocol. The primary outcome of interest included pain measured using the visual analogue scale (VAS) at 2-months follow-up. Secondary outcomes included the Harris Hip Score (HHS), the Lower Extremity Functional Scale (LEFS), EuroQoL-5 Dimensions Questionnaire (EQ-5D), and the Roles and Maudsley score. As well, incidence of complications were also measured. All secondary outcomes were measured at 1, 2, 3, and 6 months post-intervention. Results revealed that mean VAS was statistically significantly lower in the F-ESWT group compared to the sham (p<0.001) at 2-months follow-up. Furthermore, HHS, RM, and EQ-5D scores were statistically significantly improved in the F-ESWT group at all timepoints (p<0.05 for all). LEFS scores were statistically significantly improved at all timepoints in the F-ESWT group except for at 1-month follow-up (p=0.25). Finally, no complications were observed in either group.
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