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Use of ESWT on Cemented Knee replacements is it contraindicated?

Would you do ESWT on A cemented TKR or does it loosen the implant?

Suzy Seddon

8 months ago

Back to General Electrotherapy

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Prof Alison Hoens
Prof Alison Hoens

In order to respond most appropriately, I would be grateful for a little bit more information- specifically: (1) What are the signs/symptoms? (2) What is the objective for using ESWT for a TKR? - is the intent to treat pain/stiffness after a recent TKR or a new episode years post TKR? (2) Are there other medical conditions and/or potential contraindications to the use of other EPA modalities that could be used preferentially in this situation?

Prof Tim Watson
Prof Tim Watson

depends on whether your applied shockwave is focused or radial. I would not rush in with either (personally) but certainly not the focused application - higher risk of losening. In theory, the energy from radial applications will be unlikely to reach the cement (given limited penetration + the fact that the cement is encased in bone etc). The small % of energy which does reach the cement (with radial) is not going to be sufficient to bring about a loosening effect. With focused application, energy levels are higher, energy is more concentrated and it might just have an adverse effect - hence my reason for not doing it. Any help? Tim

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