| Efficacy of Extracorporeal Shock Wave Therapy for Anterior Cruciate Ligament Reconstruction: A GRADE-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| Paper ID : 1090-ISCSR3 (R1) |
| Authors |
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Ehab Naser Sabry1, Marwa Shafiek Mustafa2, Haidy .Samy Abdelmohsen3, Mariam Hesham Sallam4, Hadel Hesham Elkhodary5, Mazen Mohamed Sayed5, Ahmed Said Ashour5, Afnan Hesham Mohamed5, Manar Hassan Zaghloul5, Mariam Ismail Hassan *5, Esraa Ramadan Elbathesh5, Mohamed Emad Fahmy6, Ahmed Ibrahim Abdelhamed4 1Collage of physiotherapy, Al salam university, Egypt 21- Basic Science Department, Faculty of Physical Therapy, Cairo University, Egypt 2-Department of Physical Therapy, Faculty of Applied Medical Sciences, Al‐Zaytoonah University of Jordan, Amman, Jordan. 3Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt 4College of Physical Therapy, Misr University for Science and Technology, Giza, Egypt 5College of physical therapy, Misr University for Science and Technology, Giza, Egypt 6Biomechanics Department, Misr University for Science and Technology |
| Abstract |
| Background: Anterior Cruciate Ligament (ACL) injuries comprise approximately 50% of knee injuries. A key complication of Anterior Cruciate Ligament Reconstruction (ACLR) is failure to regain the pre-injury level. Extracorporeal Shockwave Therapy (ESWT) has been used post-ACLR for its healing effects. Objectives: To review the efficacy of ESWT on functionality and pain post-ACLR. Design of the study: Systematic Review and Meta-Analysis. Methods: Six databases were searched till December 2024 for Randomized Controlled Trials (RCTs); outcomes included functionality and pain. We used terms such as ("Extracorporeal Shockwave") AND ("Anterior Cruciate Ligament”). We screened titles, abstracts, and full texts. We used the Cochrane tool (RoB 2) to assess the risk of bias and Review Manager 5.4.1 to analyse the data. The effect size was reported as the Mean difference (MD), using the random model. We used GRADE to rate the certainty of evidence. Results: We included five RCTs (n=255), with some concern risk of bias. Low quality evidence showed that ESWT improved the International Knee Documentation Committee (IKDC ) at 3 months (MD: 7.83; 95% CI: 3.03, 12.62; I2 = 94%; P = 0.001), 12 months (MD: 6.45; 95% CI: 3.27, 9.64; I2 = 73%; P< 0.0001), but not at 6 months (MD: 6.94; 95% CI: −4.04, 17.92; I2 = 98%; P = 0.22), moderate evidence showed no improvement at 24 months (MD: 2.48; 95% CI: −0.14, 5.10; I2 = 0%; P = 0.06). Low evidence indicated pain reduction at 3 months (MD: −1.26; 95% CI: −2.37, −0.15; I2 = 98%; P = 0.03) but not at 6 months (MD: −1.28; 95% CI: −3.71, 1.15; I2 = 99%; P = 0.3). Conclusion: Low to moderate evidence indicates that ESWT significantly improved short- and long-term knee functionality and reduced short-term pain. Regarding the heterogeneity, More Standardized RCTs are needed to draw incisive conclusions. |
| Keywords |
| Shockwave Therapy, Autograft, Rehabilitation |
| Status: Abstract Accepted |