背景:体外冲击波疗法(ESWT)已用于与骨髓水肿(BME)相关的各种病理。然而,目前尚不清楚ESWT是否有利于BME的治疗.因此,本系统综述的目的是评估ESWT治疗BME的疗效.
方法:在没有时间限制的情况下搜索MEDLINE相关文献。包括随机和非随机试验。病例报告和会议摘要被排除在外。筛选标题和摘要,并检索纳入研究的全文文章。关于ESWT对疼痛的影响的数据,函数,提取磁共振成像的BME区域。
结果:疼痛,函数,和磁共振成像结果在所有研究中均有所改善-无论是随机还是非随机研究.这种效果在多种病理中一致,如股骨头坏死,BME与膝骨关节炎相关,Kienböck病,和耻骨骨炎.荟萃分析显示,疼痛(1个月后:加权平均差异(WMD)=-2.23,95%CI-2.58至-1.88,P<0.0001;3-6个月后:WMD=-1.72,95%CI-2.52至-0.92,P<0.00001)和功能(1个月后:WMD=-1.59,95%CI-2.04至-1.14,P<6=
结论:根据现有证据,ESWT可能是涉及BME的病理的保守治疗的适当选择。
背景:PROSPERO,CRD42021201719。2020年12月23日注册。
BACKGROUND: Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic
review was to assess the efficacy of ESWT for the treatment of BME.
METHODS: MEDLINE was searched for relevant literature with no time constraints. Both randomized and non-randomized trials were included. Case reports and conference abstracts were excluded. Titles and abstracts were screened and full-text articles of included studies were retrieved. Data on the effect of ESWT on pain, function, and the BME area on magnet resonance imaging were extracted.
RESULTS: Pain, function, and magnet resonance imaging results all improved across the studies - regardless of whether it was a randomized or non-randomized study. This effect was consistent across multiple pathologies such as osteonecrosis of the femoral head, BME associated with knee osteoarthritis, Kienböck\'s disease, and osteitis pubis. The meta-analysis showed that pain (after 1 month: weighted mean difference (WMD) = - 2.23, 95% CI - 2.58 to - 1.88, P < 0.0001; after 3-6 month: WMD = - 1.72, 95% CI - 2.52 to - 0.92, P < 0.00001) and function (after 1 month: WMD = - 1.59, 95% CI - 2.04 to - 1.14, P < 0.0001; after 3-6 month: WMD = - 2.06, 95% CI - 3.16 to - 0.96, P = 0.0002; after ≥ 12 month: WMD = - 1.20, 95% CI - 1.83 to - 0.56, P = 0.0002) was reduced in terms of ESWT treatment compared to a control group.
CONCLUSIONS: Based on the available evidence, ESWT may be an adequate option for conservative therapy in pathologies involving BME.
BACKGROUND: PROSPERO, CRD42021201719 . Registered 23 December 2020.