Volume 11 Issue 4 - 2020
How can we Better Know, Understand and Utilize Extracorporeal Shock Wave Therapy?
Pietro Romeo*
Galeazzi Orthopedic Institute, Via Riccardo Galeazzi, Milan, Italy
*Corresponding Author: Pietro Romeo, Galeazzi Orthopedic Institute, Via Riccardo Galeazzi, Milan, Italy.
Received: March 02, 2020; Published: March 19, 2020

From the first disruptive intent in the treatment of the kidney stones, a mistaken idea of similar effects in muscle-skeletal diseases has trapped Extracorporeal Shock Wave Therapy (ESWT) in a mechanistic limbo for many years. In spite of this, and thanks to the efforts and the determination of the researchers in the scientific community of shock waves, new perspectives overlooking the horizon have progressively overcome the old biases.


  1. D’Agostino MC., et al. “Shock wave as a biological therapeutic tool: From mechanical stimulation to recovery and healing, through Mechanotransduction”. International Journal of Surgery 24 (2015): 147-153.
  2. Wang CJ., et al. “Medial tibial subchondral bone is the key target for extracorporeal shockwave therapy in early osteoarthritis of the knee”. American Journal of Translational Research 9.4 (2017): 1720-1731.
  3. Leone L., et al. “Extracorporeal Shock Wave Treatment (ESWT) Improves in Vitro Functional Activities of Ruptured Human Tendon-Derived Tenocytes”. PLOS One 7.11 (2012): e49759.
  4. Rinella L., et al. “Extracorporeal shock waves trigger tenogenic differentiation of human adipose-derived stem cells”. Connective Tissue Research 59.6 (2018): 561-573.
  5. Muzio G., et al. “Key role of the expression of bone morphogenetic proteins in increasing the osteogenic activity of osteoblast-like cells exposed to shock waves and seeded on bioactive glass-ceramic scaffolds for bone tissue engineering”. Journal of Biomaterials Applications 29.5 (2014): 728-736. 
  6. Aicher A., et al. “Low-Energy Shock Wave for Enhancing Recruitment of Endothelial Progenitor Cells A New Modality to Increase Efficacy of Cell Therapy in Chronic Hind Limb Ischemia”. Circulation 114.25 (2006): 2823-2830. 
  7. Snyder R., et al. “Diabetic foot ulcer treatment with focused shockwave therapy: two multicentre, prospective, controlled, double-blinded, randomised phase III clinical trials”. Journal of Wound Care 27.12 (2018): 822-836.
  8. Sathishkumar S., et al. “Extracorporeal shock wave therapy induces alveolar bone regeneration”. Journal of Dental Research 87.7 (2008): 687-691.
  9. Dong L., et al. “Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis”. American Journal of Men's Health 13.2 (2019): 1557988319846749. 
  10. Li H and Liu ML. “Cardiac shock wave therapy: an alternative non-invasive therapy for refractory angina”. European Review for Medical and Pharmacological Sciences 22.16 (2018): 5402-5410.
  11. Tepeko¨ylu CG., et al. “miR-19a-3p containing exosomes improve the function of ischaemic myocardium upon shock wave therapy”. Cardiovascular Research (2019).
  12. Holfeld J., et al. “Toll-like receptor 3 signalling mediates angiogenic response upon shock wave treatment of ischaemic muscle”. Cardiovascular Research 109.2 (2016): 331-343.
  13. Lobenwein D., et al. “Shock Wave Treatment Protects From Neuronal Degeneration via a Toll-Like Receptor 3 Dependent Mechanism: Implications of a First-Ever Causal Treatment for Ischemic Spinal Cord Injury”. Journal of the American Heart Association 4.10 (2015): e002440.
  14. Sukubo NG., et al. “Effect of shock waves on macrophages: A possible role in tissue regeneration and remodeling”. International Journal of Surgery 24 (2015): 124-130.
  15. Xia J., et al. “Stem cell secretome as a new booster for regenerative medicine”. BioScience Trends 13.4 (2019): 299-307.
  16. Tepekoyl CG., et al. “Shock Wave Therapy Improves Cardiac Function in a Model of Chronic Ischemic Heart Failure: Evidence for a Mechanism Involving VEGF Signaling and the Extracellular Matrix”. Journal of the American Heart Association 7.20 (2018): e010025.
  17. Hausdorf J., et al. “Shock wave therapy for femoral head necrosis-Pressure measurements inside the femoral head”. Journal of Biomechanics 43.11 (2010): 2065-2069.
  18. Li G., et al. “Effect of the Body Wall on Lithotripter Shock Waves”. Journal of Endourology 28.4 (2014): 446-452. 
  19. Li D., et al. “3D multicellular model of shock wave-cell interaction”. Acta Biomaterialia 77 (2018): 282-291.
  20. Frairia R., et al. “Extracorporeal shock waves: perspectives in malignant tumour treatment”. Journal of Biological Regulators and Homeostatic Agents 30.3 (2016): 641-648.
  21. Cavalli R., et al. “Combining Drug-Loaded Nanobubbles and Extracorporeal Shock Waves for difficult-to-treat Cancers”. Current Drug Delivery 15.6 (2018): 752-754.
  22. Lei Zhai L., et al. “Human autologous mesenchymal stem cells with extracorporeal shock wave therapy for nonunion of long bones”. Indian Journal of Orthopaedics 50.5 (2016): 543-550. 
  23. Sansone V., et al. “A novel bimodal approach for treating atrophic bone non-unions with extracorporeal shockwaves and autologous mesenchymal stem cell transplant”. Medical Hypothesis 111 (2018): 4-7.
  24. Premi E., et al. “Modulation of long-term potentiation-like cortical plasticity in the healthy brain with low frequency-pulsed electromagnetic fields”. BMC Neuroscience 19.1 (2018): 34.
  25. Viganò M., et al. “Mesenchymal stem cells as a therapeutic target of biophysical stimulation for the treatment of musculoskeletal disorders”. Journal of Orthopaedic Surgery and Research 11.1 (2016): 163.
Citation: Pietro Romeo. “How can we Better Know, Understand and Utilize Extracorporeal Shock Wave Therapy?”. EC Orthopaedics 11.4 (2020): 54-58.

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