Lithotripsy studies on the effects of shock waves on the different tissues of the body that come into direct or indirect contact with shock waves, have also focused on bones and other tissues of the musculoskeletal system, thus showing that shock waves can have a positive effect on a wide variety of tissues. 5Įxtracorporeal shock wave therapy has been developed from extracorporeal shock wave lithotripsy (ESWL). Universität Regensburg) did not find any positive results of ESWT in the treatment of lateral epicondylitis, 3, 4 the multicentre study by Ludger Gerdesmeyer (Technische Universität München) showed significantly better results with ESWT than with a placebo. Although the work of the working groups around Michael Haake (Philipps-Universität-Marburg resp. Three multicentre studies were initiated the results of which put ESWT on a new footing scientifically. This was almost the end of ESWT, but an initiative of the German Society for Orthopaedics and Traumatology contributed to further development. An exact survey of the evidence was initiated and, finally, the report of the ‘Medical Treatment’ working committee of the Federal Committee of Doctors and Health Insurance Funds on consultations of the year 1998 for the evaluation of extracorporeal shock wave therapy (ESWT) for orthopaedic, surgical and pain therapeutic indications according to §135 para.1 SGB V of, resulted in the abolition of payment for this treatment by health insurance funds in Germany. In 1997, the uninhibited enthusiasm for ESWT as a form of therapy and the simultaneous lack of proven evidence led to the questioning of this kind of therapy especially in the country with the most frequent applications of ESWT. 1, 2 In orthopaedics, many other indications have emerged relatively quickly in addition to the application to bone, and ESWT has expanded rapidly. Several researchers at different locations discovered and tried to use the effects of shock waves on bones relatively simultaneously. The development of EWST, the physical theoretical basic knowledge and different devices for application, such as focusing devices (electro-hydraulic, piezo-electric, electro-magnetic flat, electro-magnetic cylindric) and radial devices, which are also called ballistic, started with first applications which were tested on bones by orthopaedic surgeons and traumatologists in Germany and in Bulgaria. Extracorporeal shock wave therapy (ESWT) is a non-invasive form of treatment, that has been developed from ESWL (extracorporeal shock wave lithotripsy).
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