A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF THE EFFECTIVENESS OF FOCUSED EXTRACORPOREAL SHOCKWAVE THERAPY IN THE MANAGEMENT OF GREATER TROCHANTERIC PAIN SYNDROME

Patel, Ravi; Sokhal, Balamrit Singh; Singh, Rohit; Nandra, Rajpal; Heaver, Catriona; Banerjee, Robin

Abstract

Greater trochanteric pain syndrome (GTPS) is a common issue, affecting around 1.8–5.6 individuals per 1000 in the population. Treatments such as physiotherapy, anti-inflammatory drugs, corticosteroid injections, and surgery have been used, but with limited and temporary success. Focused extracorporeal shockwave therapy (f-ESWT) has been suggested as a potential non-invasive treatment option for this challenging condition.This systematic review (SR) and meta-analysis (MA) aimed to assess the long-term effectiveness of focused extracorporeal shockwave therapy (f-ESWT) in clinical practice for treating GTPS, comparing it with control groups and/or alternative treatments from previous randomised controlled trials.A comprehensive review was conducted of electronic databases and grey literature up to July 2024. Studies involving shockwave therapy (SWT) in adults with greater trochanteric pain syndrome (GTPS), which reported measures of pain and/or function both before treatment and at follow-up, were eligible for inclusion. Meta-analysis was performed using standardised pain and functional outcomes. Each study underwent quality assessment and risk of bias evaluation, and was categorised according to the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.Three randomised control trials were included in the meta-analysis. When combining effects of ESWT for pain and functional outcomes at all timepoints, ESWT was associated with better outcomes (Hg=1.20, 95%CI 1.02–1.37). For overall pain outcomes, there was a significant difference when ESWT was used (Hg=1.23, 95%CI 0.86–1.6), this effect was not present at short-term (Hg=1.31, 95%CI -1.42–4.05) and medium term (Hg=1.34, 95%CI -3.00–5.00). ESWT provided a significant difference in overall functional outcomes (Hg=1.18, 95%CI 0.97–1.40). This difference persisted at short-term (Hg=1.18, 95%CI 0.97–1.40) and medium term (Hg=1.32, 95%CI 1.00–1.64). Long-term outcomes could not be pooled due to insufficient data.In conclusion, f-ESWT appears to provide meaningful, non-invasive relief for GTPS, enhancing both pain and function in the short and medium terms. However, the lack of long-term data necessitates further research to assess the durability of these benefits for GTPS management.

Citation

Patel, R., Sokhal, B. S., Singh, R., Nandra, R., Heaver, C., & Banerjee, R. (2025, March). A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF THE EFFECTIVENESS OF FOCUSED EXTRACORPOREAL SHOCKWAVE THERAPY IN THE MANAGEMENT OF GREATER TROCHANTERIC PAIN SYNDROME. Presented at The British Hip Society (BHS) Meeting 2025, Harrogate, England

• Presentation Conference Type: Conference Abstract
• Conference Name: The British Hip Society (BHS) Meeting 2025
• Start Date: Mar 5, 2025
• End Date: Mar 7, 2025
• Acceptance Date: Mar 5, 2025
• Online Publication Date: Mar 31, 2025
• Publication Date: Mar 31, 2025
• Deposit Date: Apr 15, 2025
• Journal: Orthopaedic Proceedings
• Print ISSN: 2049-4416
• Publisher: Bone & Joint
• Peer Reviewed: Peer Reviewed
• Volume: 107-B
• Issue: SUPP_2
• Pages: 6-6
• DOI: https://doi.org/10.1302/1358-992x.2025.2.006
• Public URL: https://keele-repository.worktribe.com/output/1195556
• Publisher URL: https://boneandjoint.org.uk/Article/10.1302/1358-992X.2025.2.006