[Treatment of heterotopic ossification by extracorporeal shock wave: 26 patients].
OBJECTIVE
To evaluate the effects of extracorporeal shockwave therapy (ESWT) on heterotopic ossification leading to functional limitations in the short and medium term.


METHODS
Twenty-six patients with heterotopic ossification received sessions of ESTW (4000 shocks, 3/s), with an energy ranging from 0.54 to 1.06 mJ/mm2, once a week for 4 consecutive weeks. Intermediary assessments performed 1 month after the last session related to pain (on a visual analog scale [VAS]), range of motion, functional independence (FIM), walking distance (whenever possible), radiology, and blood calcium and alkaline phosphatase levels. Eighteen patients with total hip arthroplasty (THA) were followed up by quiz, at 11 months, on average.


RESULTS
Heterotopic ossification was neurogenic in 5 patients and nonneurogenic in 21. The length of evolution of ossification was 32+/-21 months. The measurements showing significant improvement in the short term were pain, with a mean decrease of 4.32 to 1.14 on a VAS; joint flexion, with an mean increase of 8.18+/-11.9 degrees; and walking distance, with a mean increase from 1126 to 2776 m. The treatment was tolerated for the most part. THA cases showed a decline in factors initially shown to be improved. However, the long-term results were superior to clinical status before treatment.


CONCLUSIONS
ESWT might be an interesting treatment for heterotopic ossification and can be a complement to usual medical treatment, physiotherapy, and before surgery.
Service de médecine physique et de réadaptation, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex, France. regine.brissot@chu-rennes.fr
R
R
Brissot
A
A
Lassalle
S
S
Vincendeau
J L
JL
Polard
M
M
Fouché
D
D
Ninubona
G
G
Mahieux
J
J
Chaperon
B
B
Lobel
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019220:High-Energy Shock Waves; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology