Meta-Analysis of Extracorporeal Shock Wave Therapy in Athletes with Knee Osteoarthritis: Implications for Sports Performance and Safety

Abstract

Objective: To assess the efficacy and safety of extracorporeal shock wave therapy (ESWT) for knee osteoarthritis (KOA) specifically in athletic populations, exploring its potential to enhance sports performance and recovery.

Methods: Systematic searches were conducted in major Chinese databases including Wanfang Journal Database, China Academic Journal Full-text Database CNKI, VIP Information Chinese Journal Service Platform, and the China Biomedical Literature Database CBM. The search extended up to December 20, 2021, targeting clinical randomized controlled trials RCTs that examined the impact of ESWT on KOA among athletes. Risk of bias was evaluated using the Cochrane Handbook, and meta-analysis was performed using Review Manager 5.3.

Results: This analysis synthesized findings from 18 studies encompassing 1427 patients, predominantly athletes, revealing a significant improvement in clinical therapy success rates for KOA treated with ESWT compared to controls RR = 1.31, 95% CI [1.11, 2.05], P < 0.01. Significant enhancements were noted in ESWT Lequesne index scores, pain reduction as indicated by VAS scores, and functional recovery measured by WOMAC and Lysholm scores post-treatment. Specifically, athletes showed marked improvements in pain relief, enhanced range of motion, and superior functional outcomes, critical for athletic performance and rehabilitation.

Conclusion: ESWT presents a viable, safe treatment option for athletes with KOA, offering significant pain relief and functional benefits with minimal side effects, thereby supporting enhanced athletic performance and expedited return to sport. Despite promising results, further high-quality, multicentric RCTs with larger athlete-specific samples are necessary to validate these findings comprehensively.