Review Article

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

Table 1

Basic characteristics of included studies.

AuthorPublication yearCountryLanguageSample sizeControl groupExperimental groupOutcome measuresFollow-up timeType of OAType of ESWT

Ediz2018TurkeyEnglish73PlaceboESWT 2 times/week
Total of 5 weeks
VAS, WOMAC6 MKneeFocused ESWT
Ioppolo2018RomeEnglish58HA (3 injections of 0.5 cm3 HA)
1 time/week
Total of 3 weeks
ESWT 1 time/week
Total of 3 weeks
VAS3 MCarpometacarpal jointFocused ESWT
Lee2017KoreaEnglish61HA (1 injection of 2 mL of HA) 1 time/week
Total of 3 weeks
ESWT 1 time/week
Total of 3 weeks
VAS, WOMAC3 MKneeFocused ESWT
Lizis2017PolandEnglish40KIN 1 time/week
Total of 3 weeks
ESWT 1 time/week
Total of 5 weeks
WOMAC5 WKneeUnmentioned
Zhao2013ChinaEnglish70PlaceboESWT 1 time/week
Total of 4 weeks
VAS, WOMAC3 MKneeRadial ESWT
Liu Y2016ChinaChinese86PlaceboESWT 1 time/week
Total of 8 weeks
VAS, WOMAC3 MKneeRadial ESWT
Liu MY2017ChinaChinese158Medication (celecoxib) oral 200 mg qd
4 weeks
ESWT
1 time/week
Total of 4 weeks
VAS, WOMAC3 MKneeUnmentioned
Zhang2017ChinaChinese106Ultrasound 5 times/week
Total of 4 weeks
ESWT 1 time/5 days
Total of 5 times
VAS1 MKneeRadial ESWT
Zheng2016ChinaChinese48Medication (celecoxib) oral 200 mg qd
4 weeks
ESWT 1 time/week
Total of 4 weeks
VAS, WOMAC1 MKneeRadial ESWT
Liu WT2017ChinaChinese58Acupotomy surgeryESWT
1 time/5 days
Total of 6 times
WOMAC5 WKneeUnmentioned
ZhaoAQ2016ChinaChinese60PlaceboESWT
1 time/week
Total of 8 weeks
VAS, WOMAC2 MKneeUnmentioned
Wu2014ChinaChinese53Medication (toricoxi) oral 60 mg qd
4 weeks
ESWT
1 time/week
Total of 4 weeks
VAS6 WKneeRadial ESWT
Chen2014ChinaEnglish120Placebo
Ultrasound 3 times/week
Total of 8 weeks
ESWT 1 time/week
Total of 6 weeks
VAS2 MKneeFocused ESWT
Lee JH2017KoreaEnglish20PlaceboESWT 3 times/week
Total of 4 weeks
VAS
WOMAC
1 MKneeFocused ESWT
Zhong2019ChinaEnglish63PlaceboESWT 1 time/week
Total of 4 weeks
VAS
WOMAC
3 MKneeRadial ESWT
Wang2016ChinaChinese78Massage manipulation 1 time/2 days
10 weeks
ESWT 1 time/5 days
Total of 5 weeks
WOMAC3 MKneeRadial ESWT
Zhong2018ChinaChinese63PlaceboESWT 1 time/week
Total of 4 weeks
VAS
WOMAC
5 WKneeRadial ESWT
Xie2019ChinaChinese60Fumigation bid 3 weeksESWT 1 time/week
Total of 4 weeks
VAS3 MKneeRadial ESWT
Su2018ChinaChinese160HA (1 injection of 2 mL of HA) 1 time/week
Total of 5 weeks
ESWT 1 time/week
Total of 5 weeks
VAS
WOMAC
5 WKneeRadial ESWT
Su2019ChinaChinese120PRP (1 injection of 4 mL of PRP) 1 time/week
Total of 5 weeks
ESWT 1 time/week
Total of 5 weeks
VAS
WOMAC
5 WKneeRadial ESWT
Qi2015ChinaChinese60Acupoint moxibustion qd
4 weeks
ESWT 1 time/week
Total of 4 weeks
WOMAC6 MKneeFocused ESWT
Yang2017ChinaChinese86Fumigation qd
16 days
ESWT 1 time/5 days
Total of 4 weeks
WOMACAfter treatmentKneeRadial ESWT
Liu ZC2019ChinaChinese77HA (1 injection of 2.5 mL of HA) 1 time/week
Total of 5 weeks
ESWT 1 time/week
Total of 5 weeks
VAS
WOMAC
5 WKneeRadial ESWT
Wu TY2018ChinaChinese100Medication (celecoxib) oral 200 mg qd
4 weeks
ESWT
1 time/week
Total of 4 weeks
VAS
WOMAC
After treatmentKneeRadial ESWT
Cai2018ChinaChinese90HA (1 injection of z.5 mL of HA)
1 time/week
Total of 5 weeks
ESWT 1 time/week
Total of 5 weeks
VAS
WOMAC
3 MKneeRadial ESWT
Wei2018ChinaChinese40Massage manipulation 3 times/week
Total of 4 weeks
ESWT 1 time/week
Total of 4 weeks
VAS
WOMAC
6 WKneeRadial ESWT
Cho2016KoreaEnglish18PlaceboESWT 1 time/week
Total of 3 weeks
VAS1 WKneeFocused ESWT
Liu YX2018ChinaChinese72HA (1 injection of 20 mg of HA)
1 time/week
Total of 2 months
ESWT 2 times/week
Total of 2 months
VAS
WOMAC
2 MKneeUnmentioned
Liu BZ2019ChinaChinese63PlaceboESWT 1 time/week
Total of 4 weeks
VAS
WOMAC
3 MKneeRadial ESWT
Elerian2016EgyptEnglish60Placebo corticosteroid injection 1 time/month
Total of 2 months
ESWT
1 time/week
Total of 3 weeks
VAS
WOMAC
2 MKneeRadial ESWT
Liu WF2019ChinaChinese66Medication (celecoxib) oral 200 mg qd
4 weeks
ESWT 1 time/week
Total of 4 weeks
VASAfter treatmentKneeRadial ESWT
Dou2016ChinaChinese121UltrasoundESWTWOMAC1 MKneeFocused ESWT
1 time/2 days for first two intervals
1 time/3 days for 2nd to 6th intervals
1 time/4 days for 6th to 8th intervals

Abbreviations: RCT: randomized controlled trial; ESWT: extracorporeal shockwave therapy; HA: hyaluronic acid intra-articular injections; PRP: platelet-rich plasma; KIN: kinesiotherapy; VAS: visual analogue scale; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; W: weeks; M: months; qd: once a day; bid: twice a day; OA: osteoarthritis.