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What is different and what is the same with the ossatron-orbasone. (long)

Posted by Dr. Zuckerman on 6/25/00 at 11:31 (022371)

I am going to try and compare the two machines and give my thoughts at the same time. If i think that it is an opinion I will put opinion . It i think that it is a fact I will also state this.

Both machines use spark gap technology to deliver the joules and pressure waves to the focal point of treatment. (fact)

The focal point for the orbasone is 5-6mm. The focal point for the ossatron is 7-8mm. The greatest mpa for the orbasone 89mpa. The greatest mpa for the ossatron is 56mpa. (fact)

Both are high energy treatment machines for pf. The joules for the orbasone is .6-.8 joules/mm2. Don't know what it is for the ossatron but it is probaby the same. The orbasone can use low energy the ossatron I don't know. They both use high energy for the treatment of Plantar fasciitis. (fact)

Both machines don't change bone density or dissolve bone for pf.
(fact)

Orbasone has FDA clearance for use in the USA. The ossatron is completing FDA studies for pf in the near future. (fact)
The FDA studies that the ossatron is undergoing will be a great benefit to the public. There is no double bind studies being done with the orabsone. There are seven sites in the USA using the orbasone including myself and Dr. Emerson ( who is using the orbasone on players from the
Phoenix Suns. (basketball)

You are never going to prove which machine is better. I look at the orbasone as a dell computer, and the ossatron as a IBM computer. Same technology, different company. Which ever company is able to get a machine out to the public at a fair price so that the public can afford the cost will be the better machine in the long run. The more companies out there the more competition the lower cost for everyone.
The price for the ossatron to doctors, clinics is over five times the cost of the orbasone. The cost to go thru FDA studies adds alot of cost to the ossatron. If the ossatron was the only machine available then the cost would go up and up. I Dr. Zuckerman couldn't afford to invest over 500,000 to buy the ossatron. Some people have told me the cost is 800,000. It would be better it there would two ossatron one for plantar fasciitis and other tendonitis problems and one for bone fracture healing. (opinion). There is no need to discuss the fracture healing ability for the orbasone because it can't be use for this problem.

The most important aspect for treating humans is the doctor. I believe that you are going to find that the treatment of pf is an art as well as a science. We just can forget the art part and just focus on the science .

My twenty two years of treating feet has told me that surgery for pf is very good however two thing s can happen. One it it can take six months for pain to go away and two that a small percentage will get worse.

I like ESWT before surgery because so far I haven't seen the foot worse . According to the studies and literature there were no foot made worse. I do believe that there in one patient from Scott Study where the pateint is worse off. I can't wait until next year so that I can tell you more. That's all I have at this time.


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Re: What is different and what is the same with the ossatron-orbasone. (long)

Pauline on 6/25/00 at 14:19 (022382)

How did the Orbasone get through the FDA without the double blind studies that were required of the OssaTron? When did it get FDA
approval and what studies if any were done and when? What does it
currently carry FDA approval for?
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Johnw on 6/25/00 at 15:32 (022383)

Dr. Z.,as you know the company that manufactures the orbasone/ossanol disclaims any similarities with orthotripters. The orbasone is market cleared as a hand held therapeutic vibrator. I would like to place a friendly wager with you that after the fda has completely researched this guise, the ossanol will be removed from this market and the importer sanctioned.

You are the only person still related to this device that is speaking the truth by clearly calling the orbasone an ESWT device.If the fda agrees with you it will be removed from the market because ESWT devices are class III not class I. Millions of dollars have been spent on the ossatron to prove its safety and efficacy (still undetermined).Its a difficult, lengthy system, but it is the law and all parties should and will be held to the same standards. How would you like it if all the sudden people could hold themselves out to be podiatrist without the training and licensing because any layman could diagnose the majority of the problems you see.

Just because the orbasone can do many of the same things as the the ossatron ddoes'nt mean it should be allowed to circumvent the law.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/25/00 at 15:40 (022386)

Chronic pain relief, which what all of the machine are indicated for.
I stated FDA clearance not FDA approval. The literature is full of studies which this board has abstracts tranlating from German.There is no questions that there is relief from ESWT for pf, whether it be high or low energy. The question is proof from an independent source whether it is effective for pf. This is what the ossatron studies with the FDA should help to conclude. Just because it is FDA approved doesn't mean that all insurance companies are going to include ESWT as a benefit.

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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 15:56 (022387)

I do know that Norland medical has taken many pieces equipment thru the FDA in the past. It is their belief that the orbasone doesn't need to go thru FDA studies. As you stated before this is the first time you have gone thru the process. I use the word ESWT because that is what I was taught by you. The big question will be did you make a mistake by subjecting the ossatron to alot of money and time and increased costs by thinking that you did need to go thru FDA as a class three device. Now I am not a lawyer and it seens that the lawyers all have a different opinion as well as engineers from Norland. I can understand you feelings about the ossatron and there is nothing I can do about what has happened. I am a doctor who want to treat and help patients. I had dedicated my life to heel pain . It would be a shame if any machine that proved effective were removed because joe public will be the only one to suffer . By the way I was offered to buy into a HealthSouth Surgical Center in my area. Is the ossatron available because if the orbasone does get removed I want to make sure that as an owner we will have the opportunity to bring the ossatron to Healthsouth in my area. At one time you told me that there were contracts between Healthronic and HealthSouth . So either Norland medical is a business genius or a fool and only time will time. The law is the law and no one should circumvent the law.
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Pauline on 6/25/00 at 18:45 (022400)

Please fill me in. Without FDA studies and approval how can we be sure that a piece of equipment used for medical purposes is not quackery? The Orbasone info never uses the term Orthotripsy in its
literature, instead it is compared to other therapeutic vibrators. The OssaTron definately calls it an Orthotripter. I clearly think
there could be a difference. I'm going to press the manufacture
as to why it does not use the term Orthotripter.

I love this type of thing because it sets me up for my own research and that I will do. Can you tell me why Healthtronics only set their
studies up with Othropedic centers and not with Pods. Were any Pods
selected to help with their studies? Did anyone question them on that? Has the Orbasone been marketed to Orthopedics Centers?

I personally like the fact that clinical studies were done on the OssaTron because it seems to give it more credibility. A company that is willing to jump hoops for the FDA has nothing to hide when marketing their product. I'm not so sure about something that
just pops up on the market claiming similar credentals.

Duping the public in the medical field isn't anything new, I think there is more to this controversy. No judgement can be made until
all the cards are played.
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 20:49 (022403)

Can't use the word orthotripsy because it is trademarked by Healthronics. The orbasone is in orthopedic centers. I am told that the reason that healthronics uses orthopedic centers is due to the FDA panel only having orthopedic physicians to review its studies
Please do your research and let me know what you find out. Look into who made up the words that we uses for example orthopedic lithotripsy.
orthotripter. What mades you conclude that the orbassone just jumped into the market. Yes the USA market but what about the European and Asian markets. The ossatron has been used in Canada for years and there is no FDA approval . How come everyone uses the ossatron in Canada without FDA studies. There are alot of people on this board that went to Canada to have the ossatron treatment knowing that it didn't have FDA approval. What is going to happen if there is only one company with one machine . What is the price of the treatment going to be. Safety is an important factor, but does every x-ray company
go out and do studies on the efficiency of x-ray taking.????

posted to the eswt board . . . keyword:

Re: Therapeutic vibrator vs. orthopaedic lithotropter

Pauline on 6/25/00 at 21:32 (022404)

Good Points Dr. Z. Maybe my research will bring me to one end, that
both machines provide patients with the best possible chance for
pain relief or possible cure from PF. When all is said and done
isn't that the goal of any good physician.

The Dr. I see that keeps track of my bones for Osteoporosis is the
specialist of all specialist. He conducts all the tests on new medications and sets the standards for The Center for Diseases in Atlanta. He uses state of the art bone density scaning and would
never consider using the small heel density tests used by most GP and
OBY/Gyn because in his mind they do not give the entire picture for
the research he is conducting. He also runs more expensive lab tests on a regular basis to micro manage my bodies chemicals. This could be the same thing with EWST machines. Maybe they both do the samething but the research guy sets his standards up using the one with the most credentials.
posted to the eswt board . . . keyword:


Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 22:27 (022406)

Speaking of osteoporosis and bone density scanning: Norland medical the importer of the orbasone has the patent on and is the inventor of the dexascan for bone density machine. They arethe same company that changed the entire industry of testing years ago. So if it weren't for norland medical he wouldn't doing any testing on any bones. Don't underestimate norland medical they have been around along time. Anyway the goal is to make people better, with the least amount of trauma possilbe and that is with the use of an ESWT technology. The company with the most credentials is norland medical !!!
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/26/00 at 02:45 (022411)

With these posts I have a more complete understanding of your situation.

As I have said in my previous posts: there is no 'best' machine, and patients will have no brand loyalty. Due to the overlapping capabilities of the various ESWT devices, the only way patients can know how they were treated and compare with others, is to know the energy/pressure levels and shock number.

I agree with you (please see previous posts) that the ESWT operator is important. However the energy/pressure levels are also very important. A crystal of carbon (diamond) will not form unless the proper pressure and temperature (energy) conditions are met. In an analogous manner, the biochemical reactions required to initiate healing in various types of living tissue have specific energy and pressure requirements.

Your Orbasone energy level doesn't appear to correlate with the data on the table http://heelspurs.com/eswt/specs.html
There could be many reasons for this (typo, test method, etc.). The FDA and the Orbasone's competitors certainly have this data (discovery process). So, the only people without this information are the patients on this board.

Please See:
messages/19222.html
messages/19144.html
messages/19221.html
messages/19460.html


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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/26/00 at 09:11 (022421)

Let me try to keep it simple. We are comparing the two machines.

Energy at the focal point for orbasone for pf is .6joules/mm2
MPA 74
amount of shocks is 3000 in two directions


This is what Dr. Zuckerman does. Now let fill in the blanks with the ossatran. Just for pf. I will await your answers for this board. This is the only way to make the comparison at this point excluding the doctor

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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/26/00 at 23:34 (022461)

To paraphrase Einstein: 'Things should be made as simple as possible, but not simpler.'

Your Orbasone pressure/energy values for treating plantar fasciitis appear to be that of a very high energy device. I do not understand those values. They may be calculated, or they may be erroneous.

Use of the table http://heelspurs.com/eswt/specs.html is necessary and very easy. Once you have the peak pressure, simply scroll down the column until you find the desired information.

From your previous posts, the anesthetic you use is only approximately 15% (wt. basis) of that typically used for OssaTron patients. You have stated that your patients feel no pain during the treatment (at 74.0 MPa). OssaTron patients feel pain at the lowest setting (37.8 MPa). This discrepancy is puzzling.

As individuals, OssaTron patients receive different treatment. From the information on this board, I believe OssaTron patients are treated with a range of peak pressures (see corresponding energy levels in table) that vary from 37.8 MPa (from table) to approximately 40.0 MPa (from table and MPa=1.1(KV)+22.4, non-linearity not considered). The typical first treatment shock number appears to be 1500 at a frequency range from 1.0 Hz to 4.0 Hz.

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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/27/00 at 09:58 (022481)

It is simple!!!

I have no idea what you are talking about anesthesia. The patients are getting a sural nerve block, Posterior tibial nerve block. There is no local block better for this. The next step would be iv sedation or im sedation. It you won't or can't give me the joules at the focal point and mpa at the focal point, its ok. i would like to know but if you don't know that ok. Don't worry about. it
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

john h on 6/27/00 at 10:23 (022488)

because a device goes through FDA trials does not lead to the conclusion that all other similar devices are not equally as good or effective. Red tape over the years has frozen out of the market various devices and drugs that may have been very benefical to us all. It seem clear to me from what i have read that all of these various shock wave treatment machines do very much the same thing. the operators (doctors) may choose high or low energy or vary the pulse rates but in the final analysis your foot receives shock waves. Technicians in many if not most cases perform the procedure under the supervision of a doctor. I do not know if anyone at this point can say high energy or low energy or what pulse rate is the final answer. there may never be a final answer to that as what works on one person may not work on another. glad to see we have choices in EWST just as we have choices in type of surgery (MIS, Scope,Open). We best gather all the info we can which this board provides a good forum for and then make our decision as to what is best for us. Halleluha brothers and sister.
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/27/00 at 17:53 (022521)

Amen brother!!!
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/27/00 at 20:08 (022526)

I do believe the measured values (using a needle point hydrophone) in the table are at the focal point. The Sonocur literature value you quoted above appears to be from the section 'Total Energy Flow Density.' I'm not totally certain. Rob or David L., or others who work in the field can probably give you a more definitive answer. The corresponding OssaTron peak pressure of 37.8 MPa would have a corresponding value of 0.152 mJ/mm˛.

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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 08:20 (022550)

When you read literature they always talk about the focal point in joules/mm2 as the treatment parameter and the amount of shocks given. I got the 0.08joules/mm2 from the e-mail post from Dr. Rhompter (Spelling) from Germany. He wrote about the long term treatment of pf with the Soncur. So i am trying to compare what I am using which is between 0.6 and 0.8 joules/mm2 at the focal point. I would like to know from a clincial point of view what is the joules /mm2 at the focal point for the majority of shocks waves given and the mpa . This is something that only the patient who asks would know and the doctor, and john W. You could call and ask for your treatment records and post them so that we would know what exact treatment parameters were used, in your specific cases. In all of the cases that I have read with the ossatron literature they only talk about kV
and the amount of shocks . i am talking about the literature that was given to me by john W. years ago. These are case studies. So in the beginning i only talked about kv and pulses. Since being on this board and your help I am nowtalking about joules/mm2 and mpa. I believe one of the ways for comparision is to know the exact treatment in a specific patient. Could you give us some help.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/28/00 at 19:35 (022600)

In one of my first posts to you, I said that I knew something about ESWT. That 'something' is rather limited compared to someone who performs ESWT. Rather that my interpretation/interpolation of the treatment parameters, I believe you (and the board) would be better served by discussing the exact parameters with an ESWT practitioner.

It does appear to me, that the more severe the PF case, the more energy administered.


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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 21:59 (022607)

I guess I will just have to wait until FDA or healthronics publishes this information.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 22:04 (022608)

The last time that I spoke with the docs in Canada that performed the ossatron, the treatments were the same range in kv . I will treat some patients with high joules but it has to do were my palpation of the area during the treatment I want to make sure there is great conduction of the pressure wave to the area. I want to feel great vibration in the area of treatment. The density of the tissue will make a different in the conduction of energy in the focal point. This may have to do with scar tissue or that there is more adipose (fat)
tissue in the area of treatment.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Pauline on 6/25/00 at 14:19 (022382)

How did the Orbasone get through the FDA without the double blind studies that were required of the OssaTron? When did it get FDA
approval and what studies if any were done and when? What does it
currently carry FDA approval for?
posted to the eswt board . . . keyword:

Re: Therapeutic vibrator vs. orthopaedic lithotropter

Johnw on 6/25/00 at 15:32 (022383)

Dr. Z.,as you know the company that manufactures the orbasone/ossanol disclaims any similarities with orthotripters. The orbasone is market cleared as a hand held therapeutic vibrator. I would like to place a friendly wager with you that after the fda has completely researched this guise, the ossanol will be removed from this market and the importer sanctioned.

You are the only person still related to this device that is speaking the truth by clearly calling the orbasone an ESWT device.If the fda agrees with you it will be removed from the market because ESWT devices are class III not class I. Millions of dollars have been spent on the ossatron to prove its safety and efficacy (still undetermined).Its a difficult, lengthy system, but it is the law and all parties should and will be held to the same standards. How would you like it if all the sudden people could hold themselves out to be podiatrist without the training and licensing because any layman could diagnose the majority of the problems you see.

Just because the orbasone can do many of the same things as the the ossatron ddoes'nt mean it should be allowed to circumvent the law.
posted to the eswt board . . . keyword:


Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/25/00 at 15:40 (022386)

Chronic pain relief, which what all of the machine are indicated for.
I stated FDA clearance not FDA approval. The literature is full of studies which this board has abstracts tranlating from German.There is no questions that there is relief from ESWT for pf, whether it be high or low energy. The question is proof from an independent source whether it is effective for pf. This is what the ossatron studies with the FDA should help to conclude. Just because it is FDA approved doesn't mean that all insurance companies are going to include ESWT as a benefit.

posted to the eswt board . . . keyword:

Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 15:56 (022387)

I do know that Norland medical has taken many pieces equipment thru the FDA in the past. It is their belief that the orbasone doesn't need to go thru FDA studies. As you stated before this is the first time you have gone thru the process. I use the word ESWT because that is what I was taught by you. The big question will be did you make a mistake by subjecting the ossatron to alot of money and time and increased costs by thinking that you did need to go thru FDA as a class three device. Now I am not a lawyer and it seens that the lawyers all have a different opinion as well as engineers from Norland. I can understand you feelings about the ossatron and there is nothing I can do about what has happened. I am a doctor who want to treat and help patients. I had dedicated my life to heel pain . It would be a shame if any machine that proved effective were removed because joe public will be the only one to suffer . By the way I was offered to buy into a HealthSouth Surgical Center in my area. Is the ossatron available because if the orbasone does get removed I want to make sure that as an owner we will have the opportunity to bring the ossatron to Healthsouth in my area. At one time you told me that there were contracts between Healthronic and HealthSouth . So either Norland medical is a business genius or a fool and only time will time. The law is the law and no one should circumvent the law.
posted to the eswt board . . . keyword:

Re: Therapeutic vibrator vs. orthopaedic lithotropter

Pauline on 6/25/00 at 18:45 (022400)

Please fill me in. Without FDA studies and approval how can we be sure that a piece of equipment used for medical purposes is not quackery? The Orbasone info never uses the term Orthotripsy in its
literature, instead it is compared to other therapeutic vibrators. The OssaTron definately calls it an Orthotripter. I clearly think
there could be a difference. I'm going to press the manufacture
as to why it does not use the term Orthotripter.

I love this type of thing because it sets me up for my own research and that I will do. Can you tell me why Healthtronics only set their
studies up with Othropedic centers and not with Pods. Were any Pods
selected to help with their studies? Did anyone question them on that? Has the Orbasone been marketed to Orthopedics Centers?

I personally like the fact that clinical studies were done on the OssaTron because it seems to give it more credibility. A company that is willing to jump hoops for the FDA has nothing to hide when marketing their product. I'm not so sure about something that
just pops up on the market claiming similar credentals.

Duping the public in the medical field isn't anything new, I think there is more to this controversy. No judgement can be made until
all the cards are played.
posted to the eswt board . . . keyword:


Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 20:49 (022403)

Can't use the word orthotripsy because it is trademarked by Healthronics. The orbasone is in orthopedic centers. I am told that the reason that healthronics uses orthopedic centers is due to the FDA panel only having orthopedic physicians to review its studies
Please do your research and let me know what you find out. Look into who made up the words that we uses for example orthopedic lithotripsy.
orthotripter. What mades you conclude that the orbassone just jumped into the market. Yes the USA market but what about the European and Asian markets. The ossatron has been used in Canada for years and there is no FDA approval . How come everyone uses the ossatron in Canada without FDA studies. There are alot of people on this board that went to Canada to have the ossatron treatment knowing that it didn't have FDA approval. What is going to happen if there is only one company with one machine . What is the price of the treatment going to be. Safety is an important factor, but does every x-ray company
go out and do studies on the efficiency of x-ray taking.????

posted to the eswt board . . . keyword:

Re: Therapeutic vibrator vs. orthopaedic lithotropter

Pauline on 6/25/00 at 21:32 (022404)

Good Points Dr. Z. Maybe my research will bring me to one end, that
both machines provide patients with the best possible chance for
pain relief or possible cure from PF. When all is said and done
isn't that the goal of any good physician.

The Dr. I see that keeps track of my bones for Osteoporosis is the
specialist of all specialist. He conducts all the tests on new medications and sets the standards for The Center for Diseases in Atlanta. He uses state of the art bone density scaning and would
never consider using the small heel density tests used by most GP and
OBY/Gyn because in his mind they do not give the entire picture for
the research he is conducting. He also runs more expensive lab tests on a regular basis to micro manage my bodies chemicals. This could be the same thing with EWST machines. Maybe they both do the samething but the research guy sets his standards up using the one with the most credentials.
posted to the eswt board . . . keyword:


Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/25/00 at 22:27 (022406)

Speaking of osteoporosis and bone density scanning: Norland medical the importer of the orbasone has the patent on and is the inventor of the dexascan for bone density machine. They arethe same company that changed the entire industry of testing years ago. So if it weren't for norland medical he wouldn't doing any testing on any bones. Don't underestimate norland medical they have been around along time. Anyway the goal is to make people better, with the least amount of trauma possilbe and that is with the use of an ESWT technology. The company with the most credentials is norland medical !!!
posted to the eswt board . . . keyword:

Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/26/00 at 02:45 (022411)

With these posts I have a more complete understanding of your situation.

As I have said in my previous posts: there is no 'best' machine, and patients will have no brand loyalty. Due to the overlapping capabilities of the various ESWT devices, the only way patients can know how they were treated and compare with others, is to know the energy/pressure levels and shock number.

I agree with you (please see previous posts) that the ESWT operator is important. However the energy/pressure levels are also very important. A crystal of carbon (diamond) will not form unless the proper pressure and temperature (energy) conditions are met. In an analogous manner, the biochemical reactions required to initiate healing in various types of living tissue have specific energy and pressure requirements.

Your Orbasone energy level doesn't appear to correlate with the data on the table http://heelspurs.com/eswt/specs.html
There could be many reasons for this (typo, test method, etc.). The FDA and the Orbasone's competitors certainly have this data (discovery process). So, the only people without this information are the patients on this board.

Please See:
messages/19222.html
messages/19144.html
messages/19221.html
messages/19460.html


posted to the eswt board . . . keyword:

Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/26/00 at 09:11 (022421)

Let me try to keep it simple. We are comparing the two machines.

Energy at the focal point for orbasone for pf is .6joules/mm2
MPA 74
amount of shocks is 3000 in two directions


This is what Dr. Zuckerman does. Now let fill in the blanks with the ossatran. Just for pf. I will await your answers for this board. This is the only way to make the comparison at this point excluding the doctor

posted to the eswt board . . . keyword:


Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/26/00 at 23:34 (022461)

To paraphrase Einstein: 'Things should be made as simple as possible, but not simpler.'

Your Orbasone pressure/energy values for treating plantar fasciitis appear to be that of a very high energy device. I do not understand those values. They may be calculated, or they may be erroneous.

Use of the table http://heelspurs.com/eswt/specs.html is necessary and very easy. Once you have the peak pressure, simply scroll down the column until you find the desired information.

From your previous posts, the anesthetic you use is only approximately 15% (wt. basis) of that typically used for OssaTron patients. You have stated that your patients feel no pain during the treatment (at 74.0 MPa). OssaTron patients feel pain at the lowest setting (37.8 MPa). This discrepancy is puzzling.

As individuals, OssaTron patients receive different treatment. From the information on this board, I believe OssaTron patients are treated with a range of peak pressures (see corresponding energy levels in table) that vary from 37.8 MPa (from table) to approximately 40.0 MPa (from table and MPa=1.1(KV)+22.4, non-linearity not considered). The typical first treatment shock number appears to be 1500 at a frequency range from 1.0 Hz to 4.0 Hz.

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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/27/00 at 09:58 (022481)

It is simple!!!

I have no idea what you are talking about anesthesia. The patients are getting a sural nerve block, Posterior tibial nerve block. There is no local block better for this. The next step would be iv sedation or im sedation. It you won't or can't give me the joules at the focal point and mpa at the focal point, its ok. i would like to know but if you don't know that ok. Don't worry about. it
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

john h on 6/27/00 at 10:23 (022488)

because a device goes through FDA trials does not lead to the conclusion that all other similar devices are not equally as good or effective. Red tape over the years has frozen out of the market various devices and drugs that may have been very benefical to us all. It seem clear to me from what i have read that all of these various shock wave treatment machines do very much the same thing. the operators (doctors) may choose high or low energy or vary the pulse rates but in the final analysis your foot receives shock waves. Technicians in many if not most cases perform the procedure under the supervision of a doctor. I do not know if anyone at this point can say high energy or low energy or what pulse rate is the final answer. there may never be a final answer to that as what works on one person may not work on another. glad to see we have choices in EWST just as we have choices in type of surgery (MIS, Scope,Open). We best gather all the info we can which this board provides a good forum for and then make our decision as to what is best for us. Halleluha brothers and sister.
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Re: Therapeutic vibrator vs. orthopaedic lithotropter

Dr. Zuckerman on 6/27/00 at 17:53 (022521)

Amen brother!!!
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/27/00 at 20:08 (022526)

I do believe the measured values (using a needle point hydrophone) in the table are at the focal point. The Sonocur literature value you quoted above appears to be from the section 'Total Energy Flow Density.' I'm not totally certain. Rob or David L., or others who work in the field can probably give you a more definitive answer. The corresponding OssaTron peak pressure of 37.8 MPa would have a corresponding value of 0.152 mJ/mm˛.

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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 08:20 (022550)

When you read literature they always talk about the focal point in joules/mm2 as the treatment parameter and the amount of shocks given. I got the 0.08joules/mm2 from the e-mail post from Dr. Rhompter (Spelling) from Germany. He wrote about the long term treatment of pf with the Soncur. So i am trying to compare what I am using which is between 0.6 and 0.8 joules/mm2 at the focal point. I would like to know from a clincial point of view what is the joules /mm2 at the focal point for the majority of shocks waves given and the mpa . This is something that only the patient who asks would know and the doctor, and john W. You could call and ask for your treatment records and post them so that we would know what exact treatment parameters were used, in your specific cases. In all of the cases that I have read with the ossatron literature they only talk about kV
and the amount of shocks . i am talking about the literature that was given to me by john W. years ago. These are case studies. So in the beginning i only talked about kv and pulses. Since being on this board and your help I am nowtalking about joules/mm2 and mpa. I believe one of the ways for comparision is to know the exact treatment in a specific patient. Could you give us some help.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Duane E on 6/28/00 at 19:35 (022600)

In one of my first posts to you, I said that I knew something about ESWT. That 'something' is rather limited compared to someone who performs ESWT. Rather that my interpretation/interpolation of the treatment parameters, I believe you (and the board) would be better served by discussing the exact parameters with an ESWT practitioner.

It does appear to me, that the more severe the PF case, the more energy administered.


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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 21:59 (022607)

I guess I will just have to wait until FDA or healthronics publishes this information.
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Re: What is different and what is the same with the ossatron-orbasone. (long)

Dr. Zuckerman on 6/28/00 at 22:04 (022608)

The last time that I spoke with the docs in Canada that performed the ossatron, the treatments were the same range in kv . I will treat some patients with high joules but it has to do were my palpation of the area during the treatment I want to make sure there is great conduction of the pressure wave to the area. I want to feel great vibration in the area of treatment. The density of the tissue will make a different in the conduction of energy in the focal point. This may have to do with scar tissue or that there is more adipose (fat)
tissue in the area of treatment.
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