New study – DUOLITH® SD1 »ultra« shortens recovery times following reconstruction of the anterior cruciate ligament
Recovery following an operation on the anterior cruciate ligament (ACL) is a major challenge. A recent study¹ by Weninger et al. investigated the effect of Extracorporeal Shock Wave Therapy (ESWT) on the time to return to sport, the clinical results and MRI findings following an ACL reconstruction using hamstring tendons.
Methods
The prospective controlled study monitored 65 patients (27.7 ± 7.1 years; 35 men/30 women, all professional or amateur athletes), who had undergone a primary ACL reconstruction using hamstring tendons. The test subjects were randomised into two groups (ESWT group: 37 patients; control group: 28 patients). In addition to standard rehabilitation measures, the ESWT group received focused shock wave therapy, while the control group received only the standard rehabilitation regimen. The ESWT was carried out 4, 5 and 6 weeks after surgery in accordance with a standardised protocol (1,500 pulses/week, 0.25 mJ/mm2, 5 Hz, DUOLITH® SD1 »ultra«). Follow-ups, including the IKDC score, Lysholm score, VAS and evaluation of the return to sport, were carried out at 3, 6, 9 and 12 months after the surgery. 12 months after the operation, an MRI was carried out to investigate the development of the transplant (signal intensity ratio, SIR) and the characteristics of the femoral and tibial tunnel (bone marrow oedema, fluid build-up in the tunnel).
Results
The median time for »returning to stop-andgo sports« was 27.9 weeks (±3.0) in the ESWT group and 42.6 weeks (±5.2) in the control group (p < 0.001). The »return to running« was 10.5 weeks (±1.5) in the ESWT group and 18.5 weeks (±3.3) in the control group (p < 0.001). In the ESWT group, 31 patients achieved the »same level of activity as prior to the injury« within 12 months of surgery, while only 6 patients in the control group achieved this level. The IKDC score, Lysholm score and VAS were significantly higher in the ESWT group at all time points than in the control group (p < 0.001). The average SIR in the ESWT group was 1.81 (±0.88) compared with 2.68 (±1.04) in the control group (p < 0.01).
Summary
The study’s results show that the application of shock wave therapy following an ACL operation significantly improved patient outcomes. It was shown that the times required to »return to stop-and-go sports« and the time to »return to running« were significantly shorter in the ESWT group. The number of patients who achieved the »same level of activity as prior to the injury« was significantly higher in the ESWT group. In the authors’ opinion, the results are clinically highly significant because ESWT is a cost-effective treatment option with no relevant side effects. Further studies are required in order to confirm the results. A follow-up study with a placebo group and a double-blind protocol is currently being conducted.
1 Weninger P., et al. (2023): Extracorporeal Shockwave Therapy Improves Outcome after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendons. J. Clin. Med. 12, 3350.
https://doi.org/10.3390/jcm12103350
Here you will find information about what extracorporeal shock wave therapy (ESWT) is, which complaints can be treated, and a list of providers.
