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Original Article

Low-energy Extracorporeal Shock Wave Therapy on Chronic Epicondylitis of the Elbow: Clinical and Sonographic Study.

Jung, Kyung Hoon , Hwang, Ji Hye , Chang, Hyun Jung , Yoon, Young Cheol , Park, Min Jong , Yoo, Jae Chul , Park, Won Hah
Journal of the Korean Academy of Rehabilitation Medicine 2009;33(1):77-83.
1Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. hwanglee@skku.edu
2Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
4Department of Sports Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
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Objective
To evaluate the effect of extracorporeal shock wave therapy (ESWT) and the improvement of ultrasonographic findings in refractory chronic epicondylitis of the elbow. Method: Twenty seven patients (7 men, 20 women, mean age 47) with minimum 1 year history of chronic epicondylitis of the elbow that was unresponsive to conventional therapy were included. Each patient was treated with 3∼4 sessions of low-energy (0.06∼0.12 mJ/mm2, 2000 impulses) ESWT. A 100-point scoring system, Nirschl score and Roles and Maudsley score were evaluated before treatment and at the 3- and 6-month follow-up. Ultrasonography was performed before treatment and at the 3-month follow-up. Results: Total score of a 100-point scoring system and Nirschl score were significantly improved at the 3- and 6-month follow-up compared to before treatment (p<0.05). Follow up ultrasonography was performed in twenty one patients. Eighteen of 21 patients (85.7%) showed improvement of tendinosis and 4 of 6 patients (66.7%) showed improvement of tear and 3 of 10 patients (30.0%) showed improvement of calcification on ultrasonography. Conclusion: ESWT is safe and effective modality in the treatment of refractory chronic epicondylitis of the elbow. And ultrasonography can be a useful method to evaluate the therapeutic effect of ESWT. (J Korean Acad Rehab Med 2009; 33: 77-83)

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