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Importance of the Correct Use of Extracorporeal Shockwave Therapy

      We read “Comparison of Peritendinous Hyaluronan Injections Versus Extracorporeal Shock Wave Therapy in the Treatment of Painful Achilles' Tendinopathy: A Randomized Clinical Efficacy and Safety Study”
      • Lynen N.
      • De Vroey T.
      • Spiegel I.
      • Van Ongeval F.
      • Hendrickx N.-J.
      • Stassijns G.
      Comparison of peritendinous hyaluronan injections versus extracorporeal shock wave therapy in the treatment of painful Achilles' tendinopathy: a randomized clinical efficacy and safety study.
      with great interest and congratulate the authors for their comprehensive overview on Achilles' tendinopathy (AT). However, a major shortcoming of this article is the flawed methodology concerning study design and extracorporeal shock wave treatment (ESWT) protocol (table 1).
      Table 1Differences of ESWT parameters in AT
      ESWT Protocol for AT Lynen et al
      • Lynen N.
      • De Vroey T.
      • Spiegel I.
      • Van Ongeval F.
      • Hendrickx N.-J.
      • Stassijns G.
      Comparison of peritendinous hyaluronan injections versus extracorporeal shock wave therapy in the treatment of painful Achilles' tendinopathy: a randomized clinical efficacy and safety study.
      Evidence-based Medicine ESWT Protocol
      Inclusion criteria: symptoms duration of AT >6wk >3mo
      No. of treatment sessions 3 4
      No. of impulses (total) 1500 (4500) 2000 (8000)
      Energy flux density High energy (.65–.71mJ/mm2) Low- to midenergy (.05–.28mJ/mm2)
      Localization Technological, not medical details Clinical feedback, focusing on swelling, US
      Post-ESWT schedule Sports allowed except excessive activities Stop sports activities
      Abbreviation: US, ultrasound.
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      References

        • Lynen N.
        • De Vroey T.
        • Spiegel I.
        • Van Ongeval F.
        • Hendrickx N.-J.
        • Stassijns G.
        Comparison of peritendinous hyaluronan injections versus extracorporeal shock wave therapy in the treatment of painful Achilles' tendinopathy: a randomized clinical efficacy and safety study.
        Arch Phys Med Rehabil. 2017; 98: 64-71
        • Rompe J.D.
        • Furia J.
        • Maffulli N.
        Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial.
        Am J Sports Med. 2009; 37: 463-470
        • Vulpiani M.
        • Trischitta D.
        • Trovato P.
        • Vetrano M.
        • Ferretti A.
        Extracorporeal shockwave therapy (ESWT) in Achilles tendinopathy. A long-term follow-up observational study.
        J Sports Med Phys Fitness. 2009; 49: 171
        • Rasmussen S.
        • Christensen M.
        • Mathiesen I.
        • Simonson O.
        Shockwave therapy for chronic Achilles tendinopathy: a double-blind, randomized clinical trial of efficacy.
        Acta Orthop. 2008; 79: 249-256
        • Gerdesmeyer L.
        • Mittermayr R.
        • Fuerst M.
        • et al.
        Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.
        Int J Surg. 2015; 24: 154-159
        • Rompe J.
        • Kirkpatrick C.
        • Küllmer K.
        • Schwitalle M.
        • Krischek O.
        Dose-related effects of shock waves on rabbit tendo Achillis. A sonographic and histological study.
        J Bone Joint Surg Br. 1998; 80: 546-552