Michael Chang, M.D., Ph.D.
Department of Rehabilitation Medicine
"Extracorporeal Shock Wave Treatment in Medicine"
ABSTRACT
For over 20 years, extracorporeal shock wave lithotripsy (ESWL)
has been successfully used worldwide as a first-line treatment to disintegrate
kidney stones. Using the similar physical principle, healing potential of
extracorporeal shock wave treatment (ESWT) has been recently recognized for
many chronic human musculoskeletal conditions. These conditions include insertional/calcified
tendonopathy, fracture non-unions, chronic plantar fasciitis, lateral epicondylitis
(tennis elbow), osteonecrosis of the femoral head, heterotopic ossifications,
contractures, spasticity, degenerative joint diseases, osteochondrosis dissecans,
etc. Although some clinical trials have been demonstrated both safety
and efficacy of ESWT in many of these pathological conditions, its underlying
healing mechanisms remain unclear. Furthermore, there have been wide variations
of ESWT protocols used in these clinical trials. These treatment parameters
need to be standardized for various pathological conditions and optimized
for each patient in future ESWT applications.
This presentation describes an on-going effort to bring scientists, engineers,
industries and clinicians all together to study physics of shock wave (SW)
generation, SW propagation, SW's interaction with biological tissue and biological
responses. Our ultimate goal is to understand SW’s healing mechanisms,
to optimize treatment protocols for various pathological conditions, and to
bring ESWT to patient care with maximal safety and efficacy.