ESWT compared with control conservative management in patellar tendinopathy summary of evidence
| Outcomes | Comparisons | Relative effect (95% CI) | Patients /studies (n) | Quality of evidence (GRADE) | Clinical significance | |
| Average estimate /assumed risk in the ESWT group | Average estimate /assumed risk in the control group | |||||
| VISA-P scores Follow-up: 2–3 years | ESWT: the mean±SD VISA-P score was 92.0±10.17 | Control conservative: the mean±SD VISA-P score was 41.04±10.96 | MD 50.96 (45.26 to 56.66) The difference was both statistically and clinically significant | 50/1 | ⊕⊕ Low1,2,3 | Low level of evidence in favour of focused ESWT in VISA-P compared with control conservative treatment |
| Self-perceived recovery Follow-up: 2–3 years | ESWT: 27 of 30 (90%) participants reported excellent and good outcomes | Control conservative: 12 of 24 (50%) participants reported excellent and good outcomes | OR 9.00 (2.14 to 37.85) The difference was statistically significant | 50/1 | ⊕⊕ Low1,2,3 | Low level of evidence in favour of focused ESWT compared with control conservative treatment in overall outcomes |
| VAS pain score* Follow-up: 2–3 years | ESWT: mean±SD pain score was 0.59±1.01 | Control conservative: mean±SD pain score was 4.72±1.35 | MD −4.13 (−4.78 to 3.48) The difference was both statistically and clinically significant | 50/1 | ⊕⊕ Low1,2,3 | Low level of evidence in favour of focused ESWT compared with control conservative treatment in VAS scores |
| Patient-rated pain reduction** Follow-up: 2 to 3 years | ESWT: MD from baseline was 5.41 points | Control conservative: MD from baseline was 0.66 points | Not estimable | 50/1 | N/A | ESWT: very much improved Control conservative: no change |
*Pain scores are referred to pain at activities of daily living and load induced pain.
**Cut-off points adjusted from Farrar et al. 44
1 Only one randomised controlled trial included in analysis.
2 Level of evidence decreased due to different follow-up occasions for treatment groups.
3 Level of evidence increased due to large magnitude of effect.
ESWT, extracorporeal shockwave therapy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MD, mean difference; N/A, not available; VAS, visual analogue scale.