Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy

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Objective:To assess the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) for chronic distal biceps tendinopathy (cDBT).Design:Case–control study (level of evidence, 3).Setting:SUN Orthopaedics and Sports Medicine.Patients:Patients with a diagnosis of cDBT were recruited between January 2010 and February 2015.Interventions:Patients received a single session of rESWT (2000 shock waves with energy flux density of 0.18 mJ/mm2) or other forms of nonoperative therapy.Main Outcome Measures:Patients completed the visual analog scale (VAS), the modified QuickDASH (MQD) score, and the Roles and Maudsley (RM) score over a 12-month period.Results:Forty-eight patients completed the final review at 12 months and were included in the study. Subjects ranged in age from 30 to 64 years. Mean pretreatment VAS scores for the rESWT and control groups were 8.3 and 8.5, respectively. Three and 12 months after inclusion in the study, the mean VAS scores for the rESWT and control groups were 3.4 and 5.6 (P < 0.001) and 2.7 and 4.7 (P < 0.001), respectively. Twelve-month follow-up MQD-Sports and MQD-Work scores for the rESWT and control groups were 3.7 and 1.7 (P < 0.001) and 3.8 and 1.8 (P < 0.001), respectively. Differences in mean RM scores were statistically significant between groups at 3 months after the treatment. There were no significant complications.Conclusions:Overall, rESWT is an effective and safe treatment for cDBT.Clinical Relevance:Radial ESWT as a novel, effective, and safe treatment for cDBT.

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