Extracorporeal shock wave treatment for pain following hip replacement / 中国组织工程研究

ABSTRACT

BACKGROUND:Pain after hip replacement is a difficulty for orthopedic surgeons,and revision surgery might result in severe wound for patients undergoing hip replacement.Extracorporeal shock wave(ESWT) is certificated effective for relieving pain.OBJECTIVE:To evaluate the effects of ESWT on the pain after hip replacement.DESIGN,TIME AND SETTING:Case self-control,double-blind evaluation.The experiment was performed at the Department of Orthopaedics,Zhongnan Hospital,Wuhan University between June 2004 and February 2008.PARTICIPANTS:Fifty-one cases(61 hips) undergoing total hip replacement with pain were selected,including prosthetic loosening(cemented16 cases,20 hips;non-cement12 cases,16 hips),ectopic ossification(8 cases,10 hips),acute infection(4 cases,4 hips),chronic infection(5 cases,5 hips),soft tissue aseprtic inflammation(4 cases,4 hips) and acetabulum dislocation(2 cases,2 hips).METHODS:These patients received sessions of ESWT(4 000 shocks,3 times/s),with an energy ranging from 0.54 to 1.06 MJ/mm2,once a week for 8-12 weeks.MAIN OUTCOME MEASURES:Visual analog scale(VAS),Harris hip scores,diversity of the sclerotin surrounding the prosthesis(X-ray).RESULTS:The 51 patients were followed up for 18-64 months(4.1years in average),and 2 died during this period.The scores of VAS in non-cement,chronic infection,ectopic ossification and soft tissue aseprtic inflammation groups were significantly decreased than before treatment(P