Die Desintegrationswirkung der Stoßwellen bei der extrakorporalen Stoßwellenbehandlung der Tendinosis calcarea - ein in vitro Modell

Objective Various studies have shown the benefit of the extracorporal shock wave therapy in the treatment of the calcific tendinitis. It was the aim of this study to examine the energy needed to disintegrate a calcific deposit. Method By using the in vitro model of the pig shoulder the mechanical effects of different energy levels and impulse rates on the calcifying deposits are investigated. Results The results are showing the energy- and impulse-depending effect of the shockwaves. The disintegration of the implanted "bonn-stones" with development of an large amount of fragments smaller then 1000 microns requires an energy of 0.42 mJ/mm2 and between 2000 and 3000 impulses. Conclusions According to the experimental results a instant mechanical effect on the calcifying deposits using the ordinary parameter is unlikely. The absorption of the calcifying deposits in likely induced through cellular clearing function. Clinical trials confirmed the good therapeutical results after two sessions with at least 1500 pulses and an energy of 0.28-0.30 mJ/mm2.