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European experience

Posted by Jan Rompe on 5/23/03 at 04:45 (119725)

Two new prospective trials will be presented at the 6th Congress of the European Federation of National Associations of Orthopaedics and Traumatology
(EFORT) from June 4-10, 2003, in Helsinki, Finland.

1) N. Dastgir et al.: ESWT for treatment of plantar fasciitis.
Presentation # is O 3303

2) V. Auersperg et al.: Simultaneous local anesthesia deteriorates clinical outcome for ESWT for plantar fasciitis.
Presentation # is O 3306

Abstracts may be downloaded at: http://www.congrex.fi/efort2003/ See: EFORT Congress Abstract Book

Re: European experience

BrianG on 5/23/03 at 20:29 (119778)

Over 2,200 papers were entered, to be considered for reading!!!!! I couldn't read much, due to my Webtv toy. I would like to know more about anesthesia deteriorating the ESWT clinical outcome for PF. If anyone can read it, and give a brief report, I'd appreciate it.

When I had my 1st Dornier treatment last year, the Dornier tech mentioned they did not like to shoot the ESWT beam through the Lidocaine, etc. Therfore they had to inject the area near the insertion point, but not on it.


Re: European experience

Jan Rompe on 5/24/03 at 03:43 (119799)

after opening the pdf-file of the abstract book, press ctrl+f and search for O3303 or O3306. You will find the abstracts directly.

Re: European experience

elliott on 5/24/03 at 22:34 (119852)

Dr. Rompe, I have a question: to be honest, I was disappointed your latest article on ESWT for runners offered absolutely no information at all as to how many of them returned to running and to what level compared to previous. Why not?


Re: European experience

Jan Rompe on 5/25/03 at 03:33 (119864)

Because this aspect is not part of a single evaluation score that I know of (and I know many!). Within one year about two third of patients of the active group returned to full sports activity, and less than one third of the sham group.

Re: European experience

Archie B. on 5/26/03 at 10:08 (119950)

The article states that there is evidence that simultaneous use of local anesthesia has a negative influence on repetitive low energy application of ESWT. First or all there should be no need to inject novacaine anywhere near the area of the plantar fascii that is to be treated. A properly administered pt or medial calcaneal block with 3 cc of 1% lidocaine is all that is needed to make the treatment tolerable for 1 treatment at mid- high energy as with the Dornier EPOS. In some patients a additional small amount of lidocaine as a siral block will render the procedure virtually sensation free. I can see where flooding the foot with the contents of the chemistry store( as some docs do) and then trying to get an remedial effect with low energy cause the treatment to be compromised.

Re: European experience

Dr. Z on 5/26/03 at 19:57 (119977)

I have found that the posterior tibial nerve in addition to a sural nerve works very well with high energy ESWT. I would think that it would work even better with low energy if needed. Marcaine 0.5% plain mixed with 1% lidocaine plain is a very good combination that gives profound anesthesia

Re: European experience

Archir B on 5/27/03 at 06:14 (119992)

DR. Z-Do you careto share your thoughts about the conclusions drawn by V. Auersperg regarding the effects of local anesthesia on the outcome of ESWT with this board? Also do you care to comment on my posting?

Re: European experience

Dr. Z on 5/28/03 at 02:51 (120103)

I really don't have much to add about this article . Your point about avoiding local infiltration solved the anesthetic influence. Nerve blocks are very important when doing high ESWT . Would be interesting to do the article study with only nerve blocks . According to Sunny Jacobs patient feedback is a very important part of low energy treatment and an anesthetic should be avoided for all treatment. I do know that low energy isn't so painless in some cases