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ESWT, after failed surgery ?

Posted by BrianG on 5/28/03 at 13:13 (120162)

I copied the following abstract from the 5th International Congress of the IMST, held Feb 10-13, 2003, in Orlando Fla. This was a major meeting of the world's ESWT mover's and shakers!!! I think some of these abstracts may have been posted by Pauline a couple weeks ago.
This was written by Dr Robert Gordon, a prominant orthopedic surgeon from Canada.
Does anyone have any thoughts on this? It seems to be quite the opposite from some of the information we have read here lately.


Cut and Pasted information:

Previous Plantar Fascia Surgery and ESWT Treatment of Plantar Fasciitis
Author: Robert G. Gordon
To determine whether ESWT is effective in patent with failed plantar fascial surgery.
The success of ESWT on plantar fasciitis has been demonstrated. Numerous other treatments have been tried . Patients who had attempted mini open or endoscopic releases, and who failed after a minimum of one year were treated.
15 patients who previously had surgery on their PF were treated with ESWT 18KV, 1500 shocks. They were reevaluated at 3 months post treatment. VAS was used.
There was a trend to lowering the VAS scores in these patients. Greater than 50% reduction in pain was not seen.
ESWT does not seen as effective in reducing the patients pain in patients with previous surgery

Re: ESWT, after failed surgery ?

SteveG on 5/28/03 at 13:31 (120164)

Ya - this jumped out at me when I read the post a couple of weeks ago. This does not sound too encouraging for people with prior surgery. However, Dr. Z has mentioned several times that he has successfully treated failed surgeries. I suppose the only way to get more insight would be for someone to put together a study with failed surgery patients.

Re: ESWT, after failed surgery ?

john h on 5/28/03 at 14:06 (120174)

Steve I think Dr. Gordon in Canada may have been doing that.

Re: ESWT, after failed surgery ?

Dr. Z on 5/28/03 at 16:10 (120187)

Here is the problem with ESWT and failed surgery. What was failed with the surgery. Too much fascia cut? Nerve damage.? Still poor healing. I have cured patients with failed pf release that just didn't heal. The patients can't have nerve damage. They must still have the first step morning pain or pain and sitting for any length time as the chief complaint. Any other complaint different will reduce the chances of sucess. There is no question that this is the very difficult patient.to help but it can be done depending on the reason for the failed pf surgery in the first place

Re: ESWT, after failed surgery ?

john h on 5/29/03 at 09:18 (120261)

Steve: I know I have posted this before but in a telephone conversation with Dr. Gordon he advised me to have ESWT on my foot which had previous surgery with the Ossatron. On the other foot he said he would use the lower power machine. He indicated scar tissue as a possible issue. Dr. Gordon is one of the more experienced ESWT Physicians in Canada and has presented papers in Europe. He did consult with the Bayshore Clinic and I assume he still does. He is not married to any one machine.