Knee osteoarthritis
CONSULT TREATMENT PROTOCOL

ANATOMICAL AREAS



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GLOSSARY OF DISEASES

NameTissueType of pathologies
Acute and chronic muscle aches and pain Muscle Pain management
Acute and chronic cervical and lumbar pain Muscle Idiopathic cervical and low back pain
Acute and chronic soft tissue wounds Skin Wounds
Adhesive capsulitis Joint Capsulitis
Calcifying tendinitis of the shoulder Tendons Tendinopathy
Cellulite Skin Cellulite
Chronic distal biceps tendinopathy Tendons Tendinopathy
Chronic proximal hamstring tendinopathy Tendons Tendinopathy
Diseases secondary to trigger points and myofascial Pain Muscle Myofascial pain syndrome
Golfer’s elbow Tendons Tendinopathy
Greater trochanteric pain syndrome Tendons Tendinopathy
Insertional Achilles tendinopathy Tendons Tendinopathy
Knee osteoarthritis Joint Osteoarthritis
Medial tibial stress syndrome Tendons Tendinopathy
Mid-body Achilles tendinopathy Tendons Tendinopathy
Osgood-Schlatter disease Bone Disturbance of musculoskeletal development
Patella tip syndrome Tendons Tendinopathy
Plantar fasciopathy Tendons Tendinopathy
Primary and secondary lymphedema Skin Lymphedema
Primary long bicipital tenosynovitis Tendons Tendinitis
Proliferative connective tissue disorders Connective tissue Fibrosis
Spasticity Central nervous system Cerebral palsy and stroke
Stress fractures Bone Fracture
Subacromial pain syndrome Tendons Tendinopathy
Superficial nonunions Bone Fracture
Tennis elbow Tendons Tendinopathy
Trigger points Muscle Myofascial pain syndrome
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MORE INFORMATION

Osteoarthritis (OA) is the most common cause of pain and disability worldwide and has substantial negative impact on the quality of life of affected individuals.

Hip and knee are mostly affected, especially in the elderly population. Women are more frequently affected than men. There is no cure for OA. Therapeutic approaches aim to relieve pain and maximize functional capacity and quality of life, while minimizing adverse effects from drugs and invasive procedures.

Patients with knee OA complaining of severe disabling and refractory pain are usually referred for partial or total arthroplasty. In fact, it has been shown that total knee replacement can result in greater pain relief and functional improvement than conservative treatment alone, comprising education, dietary advice, exercise, use of insoles and pain medication.

On the other hand, total knee replacement may be associated with a greater number of serious adverse events. Besides this, partial or total knee replacement is sometimes not possible because of medical conditions, limited availability and/or excessive cost.

CLINICAL EVIDENCE

Imamura et al., J Rehabil Med 2017; 49:54-62.*

Radial extracorporeal shock wave therapy for disabling pain due to severe primary knee osteoarthritis.

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Zhao et al., J Surg Res 2013;185:661-666.*

Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial.

Note:
*Imamura et al. (2017) used the Radial handpiece, whereas Zhao et al. (2013) used the Power+ handpiece. Accordingly, the higher energy density applied by Zhao et al. (2013) may explain the difference between these two studies.

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TREATMENT PROTOCOL

Number of treatment sessions 3 to 5
Interval between two sessions 1 week
Air pressure Evo Blue® 2 to 4 bar
Air pressure Power+ 1.5 to 3 bar
Impulses 2,000 on the painful spot
Frequency 8Hz to 12Hz
Applicator 15 mm
Skin pressure Moderate to heavy

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