Effects Of Radial Extracorporeal Shock Wave Therapy On Short-Term Clinical Efficacy And Graft Maturity In Men After Anterior Cruciate Ligament Reconstruction

Objective: To investigate the effect of extracorporeal shock wave therapy(ESWT)on short-term clinical efficacy and graft maturity after the anterior cruciate ligament reconstruction(ACLR).Method: The patients accepting ACLR at the Sports Medicine Department of Shanghai Huashan Hospital between October 1th 2018 and April 1th 2019 were screened according to the inclusion and exclusion criteria,and randomly divided into a ESWT group and a control group at the fourth month after the operation.The two groups both accept a 5 weeks exercise training according to the traditional rehabilitation program,and the ESWT group combined with shock wave therapy on the basis of the exercise training.The subjective evaluation was performed at 3,5,6 month after the operation,including the Lysholm knee score,IKDC score,and the Tegner Activity score.KT-1000 and MRI were performed at 3,6 month after operation.The signal/noise quotient(SNQ)of the tibial position,intra-articular position and femoral position was calculated on the MRI,indicating the graft maturity.Result: 1.clinical efficacy : The Lysholm knee scores were statistically significant in 3 months,5 months and 6 months(ESWT group:c2=11.320,P=0.003;Control group:c2=15.826,P<0.001)but there was no significant difference between the two groups(3 month after operation:P=0.687;5 month after operation:P=0.418;6 month after operation:P=0.801).The IKDC scores were statistically significant in 3 months,5 months and 6 months(ESWT group:c2=15.167,P=0.001;Control group:c2=23.306,P<0.001)but there was no significant difference between the two groups(3 month after operation:P=0.724;5 month after operation:P=0.545;6 month after operation:P=1.000).The Tegner activity scores were statistically significant in 3 months,5 months and 6 months(ESWT group:c2=12.600,P=0.002;Control group:c2=18.195,P<0.001)but there was no significant difference between the two groups(3 month after operation:P=0.579;5 month after operation:P=0.363;6 month after operation:P=0.762).There was no significant difference in KT-1000 between the two groups compared 6 months after operation with 3 months(ESWT group:P=0.097;Control group:P=0.555),and there was no significant difference between the two groups(3 month after operation: P=0.108;6 month after operation:P=0.242).3.graft maturity :At 6 months after operation,the SNQ of the tibial position in ESWT group was significantly lower than that at 3 months after operation(t=-2.863,P=0.015),and significantly lower than that in control group(t=-3.096,P=0.005),the SNQ of the tibial position in control group was no significant difference in that at 3 months(P=0.614).At 6 months after operation,the SNQ of the intra-articular position in ESWT group was no significant difference in that at 3 months(P=0.474),and no significant difference in control group(P=0.333),the SNQ of the intra-articular position in control group was significantly higher than that at 3 months(t=2.370,P=0.042).At 6 months after operation,the SNQ of the femoral position in ESWT group was significantly lower than that at 3 months after operation(t=-2.242,P=0.047),and no significant difference in control group(P=0.321),the SNQ of the femoral position in control group was no significant difference in that at 3 months(P=0.443).Conclusion: After ACLR,ESWT was used to improve the maturity of knee graft of the tibial position in 6 months after operation.After ACLR,there was no significant improvement in the short-term clinical effect of ESWT combined exercise therapy compared with the exercise therapy alone.