Orthopaedic Journal of Sports Medicine
Radial Extracorporeal Shock Wave Therapy in Knee Osteoarthritis: A Meta-Analysis and Meta-regression of Randomized Controlled Trials
By C.L. Lopes, A.V.S.L. Lopes and F.T. De Souza.
Abstract
Objective
To evaluate the efficacy of radial extracorporeal shock wave therapy (rESWT) for pain and functional limitation in adults with knee osteoarthritis (KOA).
Methods
A systematic review and meta-analysis were conducted following PRISMA 2020 and registered in PROSPERO (CRD420251084852). Randomized controlled trials comparing rESWT with sham, no intervention, or other conservative treatments were identified through PubMed (MEDLINE), Embase, and Cochrane Library (last search August 2025). Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2.0 tool. Random-effects models were applied for continuous outcomes (mean difference [MD] with 95% CI). Heterogeneity was assessed with I², and meta-regression explored the effect of energy level and number of sessions.