Bone Marrow Edema Syndrome Of The Medial Femoral Condyle Treated With Extracorporeal Shock Wave Therapy: A Clinical And MRI Retrospective Comparative Study

Publication date: Available online 7 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Matteo Vitali, Nadim Naim Rodriguez, Alberto Pedretti, Andreas Drossinos, Pierluigi Pironti, Gaia Di Carlo, Gianfranco Fraschini
ObjectiveTo determine the validity of Extracorporeal Shock Wave Therapy (ESWT) in the treatment of Bone Marrow Edema (BME) of the medial condyle of the kneeDesignRetrospectiveStudy SettingIRCCS San Raffaele Hospital, Orthopedics Outpatient ClinicParticipantsFifty-six symptomatic patients affected by bone marrow edema of the medial condyle of the knee. Patients were equally divided in a ESWT (Extracorporeal Shock Wave Therapy) treated group and a control group, which was managed conservatively.InterventionsExtracorporeal Shock Wave Therapy delivery to the medial condyle of the affected knee.Main Outcome MeasuresClinical and Functional assessment done with the use of the Knee Society Score (KSS), both clinical and functional scores. Pain was measured with Visual Analog Scale (VAS). Bone marrow edema area was measured with Magnetic Resonance Imaging before treatment and at 4 months follow-up.ResultsClinical evaluation of patients at final follow-up of 4 months post-treatment showed a significant improvement (p< 0.0001) of symptoms and knee functionality, both for range of motion and strength in both groups VAS values saw a significant improvement (p< 0.0001) in both groups; with 3 patients in the ESWT group being pain-free (VAS=0) at 4 months follow-up. At 4 months MRI assessments on both sagittal and coronal views showed a significant reduction in bone marrow edema in the ESWT as compared to the control group.ConclusionOur findings show that this type of therapy has shown to be a valid non-pharmacological and non-invasive therapy in the treatment of spontaneous BME of the medial condyle, producing an improvement of the affected vascular and metabolic state present in this pathology through its metabolic mechanisms of action.



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