Research Progress on the Mechanism of Extracorporeal Shock Wave Therapy for Osteonecrosis of the Femoral Head
DOI:
https://doi.org/10.53469/jcmp.2025.07(03).18Keywords:
Extracorporeal shock wave therapy, Osteonecrosis of the femoral head, Bone marrow edema, Angiogenesis, ARCO classificationAbstract
Osteonecrosis of the femoral head (ONFH) is a debilitating condition characterized by impaired blood supply to the femoral head, leading to osteocyte apoptosis, structural collapse, and secondary osteoarthritis. Current therapeutic strategies range from conservative measures to surgical interventions, with extracorporeal shock wave therapy (ESWT) emerging as a promising non-invasive approach. This review synthesizes recent advancements in understanding the mechanisms and clinical efficacy of ESWT for ONFH. Accumulating evidence indicates that ESWT alleviates pain, improves hip function, and delays disease progression by enhancing angiogenesis, reducing bone marrow edema (BME), and modulating inflammatory pathways. Clinical studies report significant improvements in Harris Hip Scores (HHS) and reductions in visual analog scale (VAS) pain scores, particularly in early-stage (ARCO I–II) ONFH. Long-term follow-up data (up to 10 years) highlight its potential to reduce the need for total hip arthroplasty (THA). However, heterogeneity in treatment protocols and the absence of standardized guidelines necessitate further investigation. This review provides a comprehensive analysis of ESWT’s therapeutic mechanisms, clinical outcomes, and future directions.
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Copyright (c) 2025 Tong Ke, Yangquan Hao, Hanbo Xu, Jiming Jin, Chao Lu
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