Acknowledgments

A heartfelt thank-you to Lowell Weil Sr. for giving me the courage to write a book in a foreign language, for reviewing this work, and for his invaluable help in handling many details with Thieme Publishers.

It is with grateful appreciation that I acknowledge the skill and dedication of Erwin Scholtz and Barbara Hof-Barocke in rendering the medical illustrations. They gave the art for this book high priority, and I am appreciative of their devotion to this work.

A note of appreciation is also given to Dr. Clifford Bergman who served as an invaluable interface with Thieme Publishers in taking care of numerous details that led to the completion of this book. In the shortest time possible he initiated publication of this work.

Contents

1 Physical Characteristics of Shock Waves 1

Physics 1

Acoustic Properties of Media 2

Cavitation 3

Shock Wave Generation 4

2 Dose-Dependent Effects of Extracorporeal Shock Waves on Rabbit Achilles Tendon 7

Introduction 7

Materials and Methods 8

Results 10

Sonography 10

Histopathology 11

Discussion 14

3 Dose-Dependent Effects of Extra-corporeal Shock Waves on Rabbit Sciatic Nerve 17

Introduction 17

Materials and Methods 17

Results 18

Discussion 21

4 Dose-Dependent Effects of Extracorporeal Shock Waves in a Fibular-Defect Model in Rabbits 23

Introduction 23

Materials and Methods 24

Results 27

Discussion 29

5 Extracorporeal Shock Wave Application in the Treatment of Chronic Plantar Fasciitis 33

Introduction 33

Materials and Methods 33

Inclusion Criteria 33

Exclusion Criteria 33

Randomization 33

Group 1 33

Group II 33

Method of Treatment 35

Method of Evaluation 36

Primary Outcome Measure 36

Secondary Outcome Measures 36

Statistics 36

Results 36

Follow-up 36

Primary Outcome Measure 36

Secondary Outcome Measures 36

Pressure Pain 36

Night Pain and Resting Pain 36

Walking 36

Radiographic Evaluations 36

Complications 36

Additional Treatment between 3 and

6 Months 36

Additional Treatment during the 5 Years 36

Discussion 36

Conclusion 36

6 Extracorporeal Shock Wave Application in the Treatment of Chronic Tennis Elbow 39

Introduction 39

Materials and Methods 40

Inclusion Criteria 40

Exclusion Criteria 41

Group 1 41

Group II 41

Method of Treatment 41

Method of Evaluation 43

Statistics 43

Results 44

Additional Treatment 44

Complications 44

Discussion 45

Conclusion 45

7 Extracorporeal Shock Wave Application in the Treatment of Chronic Calcifying Tendinitis of the Shoulder 49

Introduction 49

Materials and Methods 49

Inclusion Criteria 50

Exclusion Criteria 50

Group 1 51

Group II 51

Method of Treatment 53

Method of Evaluation 53

Radiological Evaluation 54

Statistics 54

Results 54

Rate of Follow-up 54

Clinical Outcome in the University of California Los Angeles Score 54

Radiological Outcome 55

Radiomorphological Features and Clinical Outcome 56

Hospital Stay 57

Absence from Work 57

Complications 57

Subjective Rating 57

8 Extracorporeal Shock Wave Application in the Treatment of Nonunions 61

Introduction 61

Materials and Methods 61

Inclusion Criteria 61

Exclusion Criteria 63

Method of Treatment 63

Method of Evaluation 64

Results 64

Discussion 67

References 71

Index 79

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