Efficacy of extracorporeal shock wave therapy for anterior cruciate ligament reconstruction: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials

Q4 Health Professions

Fisioterapia Pub Date : 2026-07-01 Epub Date: 2026-03-19 DOI:10.1016/j.ft.2026.02.005

E. Naser, M.S. Saleh, H. Samy, M. Hesham Sallam, H. Hesham Elkhodary, M. Mohamed Sayed, A. Said Ashour, A. Hesham Mohamed, M. Hassan Zaghloul, E. Ramadan Elbathesh, H. Vaish, M.E. Fahmy Mohamed, A. Ibrahim Abdelhamed

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Abstract

Introduction and objectives

We aimed to investigate the efficacy of extracorporeal shock wave therapy (ESWT) on knee functionality, pain, range of motion (ROM), gait, postural control, and bone mineral density (BMD) in patients with anterior cruciate ligament reconstruction (ACLR).

Materials and methods

Six databases were systematically searched for randomized controlled trials (RCTs). The methodological quality was assessed using the Cochrane Risk of Bias tool (ROB 2.0). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE). Meta-analysis was conducted using Review Manager.

Results

We included five RCTs (n = 255). ESWT significantly improved knee function, as measured by IKDC at three months (MD: 7.83, 95% CI: 3.03, 12.62, P = 0.001; 95% PI: −52.58, 68.24) and 12 months (MD: 6.45, 95% CI: 3.27, 9.64, P < 0.0001; 95% PI: 76.14, 93.96), and as measured by the Lysholm score at three months (MD: 8.91, 95% CI: 2.02, 15.80, P = 0.01), 12 months (MD: 7.20, 95% CI: 6.33, 8.06, P < 0.00001), and 24 months (MD: 5.94, 95% CI: 3.18, 8.71, P < 0.0001). These changes did not exceed the clinically important difference. ESWT reduced pain after three months (MD: −1.26; 95% CI: −2.37, −0.15; P = 0.03; 95% PI: −15.53 to 13.01). Pooling data on other outcomes was unfeasible.

Conclusion

This systematic review indicates that ESWT may provide significant short and long-term functional improvements, with no clinically important benefits. Also, it may decrease short-term pain. Given low to moderate evidence, future high quality RCTs are indicated.

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体外冲击波治疗前交叉韧带重建的疗效：一项grade评价的系统评价和随机对照试验的荟萃分析

前言和目的我们旨在研究体外冲击波治疗（ESWT）对前交叉韧带重建（ACLR）患者的膝关节功能、疼痛、活动范围（ROM）、步态、姿势控制和骨密度（BMD）的影响。材料与方法系统检索6个数据库的随机对照试验（rct）。采用Cochrane风险偏倚工具（ROB 2.0）评估方法学质量。采用推荐、评估、发展和评价分级法（GRADE）评价证据的质量。meta分析使用Review Manager进行。结果纳入5项随机对照试验（n = 255）。ESWT显著提高膝关节功能,以IKDC在三个月(MD: 7.83, 95% CI: 3.03, 12.62, P = 0.001; 95%π:−52.58,68.24)和12个月(MD: 6.45, 95% CI: 3.27, 9.64, P & lt; 0.0001; 95%π:76.14,93.96),并以Lysholm得分在三个月(MD: 8.91, 95% CI: 2.02, 15.80, P = 0.01), 12个月(MD: 7.20, 95% CI: 6.33, 8.06, P & lt; 0.00001),和24个月(MD: 5.94, 95% CI: 3.18, 8.71, P & lt; 0.0001)。这些变化没有超过临床上重要的差异。ESWT减轻了3个月后的疼痛（MD: - 1.26; 95% CI: - 2.37, - 0.15; P = 0.03; 95% PI: - 15.53至13.01）。汇集其他结果的数据是不可行的。本系统综述表明，ESWT可能提供显着的短期和长期功能改善，但没有临床重要的益处。此外，它可能会减少短期疼痛。鉴于低至中等证据，建议未来进行高质量的随机对照试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fisioterapia Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

0.50

自引率

0.00%

发文量

期刊介绍： Publicación Oficial de la Sociedad Española de Fisioterapeutas. Sus páginas ofrecen desde artículos originales hasta revisiones, pasando por el estudio de casos o los actos más importantes relacionados con la especialidad.