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California Foot & Ankle Institute

Extra-Corporeal Shockwave Technology

Extra-Corporeal Shockwave Technology with OssaTron is a high energy shock wave system with low energy intensity, that provides a non-surgical alternative for patients diagnosed with chronic proximal plantar fasciopathy (severe heel pain), usually referred to as fasciitis.  Using a unique process known as Orthotripsy, the OssaTron emits shock waves, similar to those used to treat kidney stones, in an attempt to increase blood flow and stimulate healing of the affected heel.  ESWT with OssaTron treatment protocols may require more than one treatment.  It is also effective in the treatment of chronic lateral epicondylitis, or chronic tennis elbow.heel-pain

The procedure can be done on an outpatient basis under local anesthesia.  It takes about 30 minutes to perform and is done so at significantly lower cost than conventional surgery.  Patients can bear weight immediately and return to normal activity within days of the procedure.   These waves are directed onto the heel of the foot in the case of plantar fasciitis and the elbow in cases of chronic lateral epicondylitis.

OssaTron is the first and only system approved by the U.S. Food and Drug Administration (FDA) for ESWT.  The OssaTron is a welcome option for many that suffer from tendinitis and plantar fasciitis.  Approximately 25% of the population has pathological bone and joint conditions, calcification or diseases of the tendon.  This painful and frequently debilitating ailment is often job or sports related and many times contributes to loss of work. 

Plantar Fascitis

Plantar fasciitis is a very common ailment characterized by deep pain in the plantar aspect of the heel, particularly on arising from bed. While the pain may subside with activity, in some patients the pain may persist, interrupting activities of daily living.  On physical examination, firm pressure will elicit a tender spot over the medial tubercle of the calcaneus.  The exact etiology of plantar fasciitis is unclear, although repetitive injury is suspected.  Heel spurs are a common associated finding, although it has never been proven that heel spurs cause the pain.  It should be noted that asymptomatic heel spurs can be found in up to 10% of the population.

eswtTendinitis of the Elbow (Lateral Epicondylitis)

Lateral epicondylitis is the most common form of tendinitis of the elbow and results in lateral elbow pain and functional limitations. The disorder is caused by overuse or injury of the tendons that attach the arm muscles to the elbow, one may commonly hear the term “tennis elbow” from playing tennis.   However, only a minority of cases are caused by playing tennis; the majority occur from other activities that involve repetitive extension of the wrist.  Overuse of the extensor muscles leads to microtears at their insertion point, which incites an inflammatory response.  Repetitive cycles of injury and inflammation lead to tendinosis, degeneration of the tendon structures, and disorganized healing.

Procedure

Once anesthesia has been administered, high viscosity ultrasoundgel is applied to the area experiencing pain.  The gel promotes shock wave conductance, enhancing the treatments effectiveness.  The Ossatron Application Technician then activates the shock wave via the shock wave release hand piece on the console. The treatment is an outpatient procedure that takes less than 20 minutes to perform and is indicated for patients who are nonresponsive to other conservative treatment for six months or more.   

The OssaTron uses an electrohydraulic method of generating shock waves, which are focused so that they converge at a point near the surface of the foot.  Typically, 1,500 shocks are necessary for treatment, which is performed on an outpatient surgical center under local or general anesthesia.

Post Procedure

It is recommended after treatment that the patient restrict "stressful activity" such as jogging, heavy housework or yard work, and participating in sports for four weeks. Pain relief begins for patients at different times. For some patients it is immediate; for others it may take four weeks. The full effect of the OssaTron procedure may not be realized until the twelfth week following treatment.  If relief has not been achieved at this point, a second OssaTron procedure may be recommended. 

Success Rate

Claims suggested that Orthotripsy with the OssaTron has been proven to be effective over 80% of the time with only one treatment. Some patients report immediate pain relief after treatment, although it can take up to four weeks for pain relief to begin.