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Monday, December 31, 2018

Sesamoid AVN improved by Shockwave and HBO treatments: Sesamoid Relief

This was a response to my blog post. This wonderful patient sent me 2 articles on the use of Shockwave therapy on AVN for sesamoids.

Thank you for your answer Rich :)
I will follow your advices and ask my doc about a CT scan and Vitamin D check.

I am attaching 2 articles about the use of shockwave therapy in sesamoid injuries, for sure it will be of interest for you.

About the help/use of HBO I did not find any reports in English, but here in Germany you find this information on many medical websites (mainly for AVN in the hip and knee). I had contact with one doc who confirmed that he personally made good experience in treating bone marrow edema and AVN in the foot (ankle and sesamoids) with HBO.

I keep you updated.
Have a good start in the new year!

Dr. Blake's comment:
The 2 articles are following:

1)   Saxena A, Yun A, Patel R, Gerdesmeyer L, and Maffuli N. Radial Soundwave for Sesamoidopathy in Athletes: Pilot Study. J.Foot Ankle Surg 55(2016): 1333-1335

The treatment protocol that showed promise was 3 treatments 1 week apart. The treatments were 2500 pulses per session, 2.4 Bar and 13 Hz.

2)   Thompson D, Malliaropoulos N, and Padhiar N. Sesamoid Osteonecrosis treated with Radial Extracorporeal Shockwave Therapy. Brit Med Journal Case Report 2017 (accepted 5 May 2017).

The treatment protocol that showed promise was 8 sessions, 2000 pulses per session, 1.2 to 1.8 Bar of pressure to patient tolerance, 5 Hz.

I am so excited that another help for these sesamoid injuries with avascular necrosis has settled in. I currently have 2 patients that are fine, but any running keeps irritating the sesamoid area with some avn issues. With new techniques, medicine has to find the place for it. When do we offer it to patients, at the first sign of problems, or only after bone stimulator for 9 months? For me now, it is for the few patients (less than 5%) that seem to have issues after extensive treatment and are considering sesamoid removal. But, it may be appropriate much earlier in the treatment.

1 comment:

  1. This information is meaningful and magnificent which you have shared here about the Shockwave Therapy. I couldn't find any knowledge on this matter prior to. I would like to thanks for sharing this article here. Shockwave Therapy Canada


Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.