Search Results (151)

Background: Chronic insertional Achilles tendinopathy (CIAT) is a type of tendinopathy resistant to conventional conservative treatments. The efficacy of extracorporeal shock wave therapy (ESWT) remains controversial. This study aims to evaluate the effects of ESWT on pain management and functional improvement in CIAT patients and compare it with physical and medical treatments Methods: In this retrospective study, 372 patients diagnosed with CIAT between 2019 and 2023 were evaluated. The patients were divided into two groups: those who received only physical/medical therapy (Group 1) and those who underwent a combination of ESWT and physical/medical therapy (Group 2). Clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score and the Visual Analog Scale (VAS) scores. The severity of the disease was determined through magnetic resonance imaging (MRI). Group comparisons were conducted using the independent samples t-test and Fisher’s exact test, while changes over time were assessed with repeated measures ANOVA. Correlation analyses were evaluated using Pearson and Spearman correlation coefficients. Results: Significant improvement in AOFAS and VAS scores was observed in both groups by the third month (p < 0.01). However, at 6 and 12 months, ESWT did not demonstrate superiority over physical/medical treatment. Correlation analysis showed a positive relationship between baseline AOFAS scores and functional improvement, while higher initial VAS scores correlated with greater post-treatment pain reduction. Cardiovascular risk factors negatively impacted both functional recovery and pain reduction (p < 0.05). Although patient satisfaction was higher in the ESWT group, the difference was not statistically significant. Conclusions: ESWT may provide short-term pain relief and functional improvement in CIAT but does not offer a long-term advantage over physical/medical treatment. The placebo effect may contribute to early positive outcomes. These findings do not support ESWT as a routine treatment for CIAT. Full article

Background/Objectives: Radial extracorporeal shock wave therapy (rESWT) is used to treat neuromuscular disorders such as spasticity, but the mechanisms by which rESWT modulates muscle tone remain incompletely understood. One proposed mechanism involves mechanical perturbation of the neuromuscular junction (NMJ), particularly destabilization of acetylcholine receptor (AChR) clusters in the postsynaptic membrane. Because rapsyn knockout mice are not viable, Caenorhabditis elegans (C. elegans) provides an alternative model for studying neuromuscular signaling, expressing the rapsyn homolog RPY-1, a postsynaptic scaffolding protein involved in AChR organization at the NMJ. This study examined whether loss of RPY-1 alters locomotor responses of C. elegans to radial extracorporeal shock wave (rESW) exposure. Methods: Wild-type worms and rpy-1 knockout worms (rpy-1-KOs) were exposed to defined numbers of rESWs. Locomotor behavior was quantified using automated tracking of parameters describing speed, trajectory and body-wave dynamics. Behavioral responses were analyzed both as absolute values and relative to genotype-specific baseline values. Results: rESW exposure produced pronounced alterations in locomotor behavior across all parameters analyzed. Absolute values revealed baseline differences between genotypes. After normalization to genotype-specific baseline values, wild-type worms and rpy-1-KOs responded similarly to moderate exposure levels. At higher exposure levels, genotype-dependent differences became more apparent. Locomotor impairment was most pronounced immediately after exposure but improved during the subsequent recovery period of three hours. Conclusions: rESWs induced strong but largely reversible locomotor alterations in C. elegans during the first hours after exposure. Loss of the rapsyn homolog RPY-1 modified these responses, particularly at higher exposure levels. These findings indicate that RPY-1 influences behavioral responses to rESW exposure, while direct effects on NMJ structure or AChR organization cannot be determined from the present data. Full article

Background: Chronic plantar fasciitis refractory to conservative treatment is a frequent cause of persistent heel pain and functional limitation. Although radial extracorporeal shock wave therapy (rESWT) has shown potential benefit, the relationship between clinical improvement and structural ultrasonographic changes remains unclear. The aim of this study was to evaluate the clinical, functional, and ultrasonographic outcomes associated with rESWT in patients with refractory plantar fasciitis. Methods: We conducted a prospective observational single-center study including 287 patients with plantar fasciitis refractory to conservative treatment for at least 6 months and confirmed by ultrasonography (plantar fascia thickness >4 mm). All patients received four weekly sessions of rESWT. Pain intensity (visual analog scale [VAS]), foot function (Foot Function Index [FFI]), quality of life (EQ-5D), and plantar fascia thickness were assessed at baseline and 3 months after treatment. Results: Significant improvements were observed in pain (mean VAS change, −3.73 points), function (mean FFI-disability change, −32.37 points), and quality of life (improvement in at least one EQ-5D dimension in 81.5% of patients) (all p < 0.001). The mean reduction in plantar fascia thickness was 0.14 mm. Most responders (71.8%) showed clinical improvement despite the absence of a relevant structural change, defined as a reduction in plantar fascia thickness <0.5 mm. In multivariate analysis, physically demanding occupations were associated with a lower probability of response (odds ratio, 0.32; 95% confidence interval, 0.17–0.63). The prognostic model showed moderate discrimination (area under the curve, 0.71). Conclusions: In this observational cohort, rESWT was associated with improvements in pain, function, and quality of life in patients with refractory plantar fasciitis. Clinical improvement frequently occurred despite minimal changes in plantar fascia thickness, suggesting that ultrasonographic thickness may not adequately reflect symptomatic evolution. However, the absence of a control group prevents causal interpretation of these findings. Full article

The diagnosis of spinal cord injury (SCI) remains associated with a poor prognosis due to limited treatment options and the absence of curative therapies. Optimizing treatment strategies is therefore crucial to enhance patients’ quality of life, reduce mortality and re-hospitalization rates, and lower overall therapy costs. Shock wave therapy (SWT) is a well-established regenerative treatment option for pathologies of the musculoskeletal system that delivers high-energy acoustic waves. SWT is non-invasive, safe and cost-effective. Preclinical and clinical evidence is emerging, showing the efficacy of SWT in the treatment of both traumatic and ischemic SCI. This systematic review synthesizes evidence on SWT in SCI from 2000 to 2025, excluding case reports and non-regenerative applications. Results were categorized into preclinical and clinical studies, with preclinical findings further divided into functional, histological, cellular, and molecular outcomes. Promising preclinical results led to initial clinical studies, which demonstrated the safety and feasibility of SWT, with a randomized controlled trial currently ongoing (ClinicalTrials.gov: NCT04474106). Overall, the encouraging evidence suggests that SWT is a promising novel regenerative treatment option for SCI, although further research is needed to define optimal treatment protocols and to establish its role in standard clinical care. Full article

Purpose: This study compared the therapeutic efficacy of different bladder monotherapies and multimodal therapy in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Materials and methods: In total, 190 patients with a confirmed diagnosis of IC/BPS were treated with different bladder therapies. The bladder monotherapies included intravesical platelet-rich plasma (PRP) injection (n = 60), intravesical botulinum toxin A (BoNT-A) injection (n = 33), intravesical hyaluronic acid (HA) instillation (n = 36), and low-energy shock wave (LESW) bladder therapy (n = 61). Multimodal therapy (MMT) was provided to patients who had unsuccessful initial bladder treatment targeting chronic inflammation, urothelial dysfunction, bladder pain, pelvic floor muscle pain, psychological stress, and lower urinary tract dysfunction. The treatment outcome was assessed using self-reported Global Response Assessment scores at 3 months and during the follow-up time points after bladder treatment. Results: Thirty-one patients received MMT. The 3-month success rates of bladder therapy were 55.0% for PRP injection, 57.6% for BoNT-A injection, 50.0% for HA instillation, 46.7% for LESW bladder therapy, and 58.1% for MMT. The success rates of bladder monotherapy decreased after 6 months. However, the success rate of MMT increased at 9 (67.7%) and 12 (73.1%) months. Patients treated with MMT exhibited improvement in glomerulation grade after cystoscopic hydrodistention. Only patients with successful treatment outcomes after MMT had improvement in bladder pain severity and pelvic floor muscle pain parameters. Conclusions: Bladder monotherapy such as PRP injection, BoNT-A injection, HA instillation, and LESW bladder therapy had successful treatment outcomes in patients with IC/BPS. In patients who had unsuccessful initial bladder therapy, the 3-month success rate of MMT was 58.1% and sustained improvement with time, particularly in the improvement of bladder pain and PFM pain severity. Full article

Botulinum toxin type A (BoNT/A) injection into the bladder wall is a milestone in the treatment of urinary incontinence in patients with neurogenic detrusor overactivity (NDOi) or overactive bladder syndrome (OABi) who are refractory to or unable to tolerate oral or transdermal therapies. However, the efficacy of BoNT/A is hampered by the low long-term adherence of patients to a treatment that requires repeated bladder injections under cystoscopy control. The discontinuation is particularly evident among incontinent patients with spontaneous voluntary voiding, regardless of whether the cause is NDOi or OABi, although clearly more marked among the latter group. In addition to the bother and pain associated with repeated cystoscopies, these patients show low tolerance to the high incidence of urinary tract infections (UTIs) and transient urinary retention, the two most common adverse events. Fewer injection points may render treatments less painful, apparently without reducing efficacy, but will not avoid the need for repeated cystoscopies, and no studies have demonstrated that such modification increases adherence. Eventually, accessing the bladder wall for BoNT/A administration via a transabdominal approach, under real-time ultrasound guidance, may overcome trans-urethral limitations, but the technique’s reproducibility remains unknown. An intensive investigation is ongoing to identify aids that facilitate the passage of the large, fragile BoNT/A molecule across the urothelium to reach the bladder nerves without injections. Electromotive Drug Administration (EMDA) of BoNT/A demonstrated efficacy and safety over a 6-year follow-up in NDOi patients at a single center, but the results were not reproduced at other institutions. The application of shock waves to the bladder using shock waves generated by Extracorporeal Shock Wave Lithotripsy (ESWL) machines to tear the urothelium and facilitate the passage of BoNT/A instilled in the bladder is ingenious, but the experience is very limited. Dimethyl sulfoxide, liposomes, and thermal-reversal hydrogel to deliver the toxin failed in pilot trials. BoNT/A in nano-formulations has high heat stability, resistance to pH changes, and to enzymatic degradation. Extended efficacy in dermal and intramuscular pilot applications is promising but needs to be replicated in the bladder. Full article

Background/Objectives: To evaluate whether adjunctive silodosin improves the stone-free rate (SFR) and clinical outcomes of extracorporeal shock wave lithotripsy (ESWL) for renal calculi. Methods: In this prospective randomised controlled trial, 100 adults with solitary radiopaque non-lower pole renal stones measuring 5–20 mm underwent single-session ESWL and were randomised (1:1) to receive either silodosin 8 mg once daily plus standard care or standard care alone for up to 12 weeks. Participants were followed up for three months. The primary outcome was SFR at three months on follow-up imaging. The secondary outcomes included time to stone clearance, renal colic episodes, analgesic requirement and adverse events. Results: At three months, the SFR was higher in the silodosin group than in the control group (68.0% vs. 50.0%; RR 1.36, 95% CI 0.97–1.90), but this difference did not reach statistical significance (p = 0.067). In a prespecified exploratory subgroup analysis, patients with stones measuring 10–20 mm showed a higher SFR with silodosin than controls (61.8% vs. 34.4%; p = 0.026), whereas no benefit was observed for stones measuring 5–9 mm (p = 0.803). Time-to-clearance analysis using Kaplan–Meier methods suggested earlier confirmed stone clearance in the silodosin group (hazard ratio 1.58, 95% CI 1.02–2.45; log-rank p = 0.036). Silodosin was also associated with fewer renal colic episodes and lower analgesic requirements. No serious drug-related adverse events were observed. Conclusions: This randomised controlled trial did not meet its primary endpoint because adjunctive silodosin did not significantly improve the overall SFR after ESWL. However, a possible benefit was observed in patients with renal stones measuring 10–20 mm, together with improved pain-related outcomes. These findings suggest that silodosin may have a role in selected patients, but the subgroup effects should be considered hypothesis-generating rather than definitive. Full article

Background/Objectives: This systematic review and meta-analysis was designed to examine the efficacy of extracorporeal shock wave therapy (ESWT) and ultrasound therapy in the treatment of upper and lower limb tendinopathies. Methods: The protocol was registered in PROSPERO (CRD420251113976) and conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Electronic searches were performed in the PubMed, Embase, EBSCOhost, and Ovid MEDLINE databases up to August 2025, to identify randomized controlled trials (RCTs). Mean differences (MDs) and standardized mean differences (SMDs) were calculated with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, and a random-effects model was applied. Risk of bias was evaluated using the Risk of Bias (RoB 2) tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Fourteen RCTs involving 639 patients with tendinopathies were included. All studies were characterized by a high risk of bias. Very low-certainty evidence suggested that ESWT as monotherapy may reduce pain at rest compared with ultrasound therapy in patients with lateral epicondylitis (MD = −1.51; 95% CI: −2.71 to −0.31; p = 0.01), although the effect was highly heterogeneous (I² = 89.8%; p = 0.002). In patients with upper- and lower-limb tendinopathy, ESWT combined with pharmacotherapy resulted in significantly lower pain intensity compared with ultrasound therapy combined with pharmacotherapy (SMD = −0.6; 95% CI: −1.07 to −0.14; p = 0.01). No significant differences in PRTEE (Patient-Rated Tennis Elbow Evaluation) scores were observed between ESWT and ultrasound monotherapy in patients with lateral epicondylitis (MD = −1.06; 95% CI: −11.06 to 8.94; p = 0.83; I² = 75.82%), or between ESWT combined with other conservative treatments and ultrasound combined with other conservative treatments (MD = 0.46; 95% CI: −10.22 to 11.15; p = 0.93; I² = 0%). Conclusions: Very low-certainty evidence suggests that ESWT may be more effective than ultrasound therapy in reducing pain when used as monotherapy in lateral epicondylitis, despite substantial heterogeneity, and when combined with pharmacotherapy in upper- and lower-limb tendinopathies. In terms of function, ESWT appears to provide improvements comparable to those of ultrasound therapy, as assessed by PRTEE scores, in patients with lateral epicondylitis, both as monotherapy and when combined with other conservative treatments. However, significant methodological limitations substantially limit confidence in these findings. Full article

Background: Upper-limb rehabilitation is a decisive factor in improving the quality of life for patients who have experienced a stroke. Modern rehabilitation techniques promote the recovery of upper-limb functionality and prehension, contributing to a reduction in disability. Materials and Methods: This retrospective observational study aimed to highlight improvements in prehension through the application of current actual and modern rehabilitation techniques targeting key muscle groups involved in upper-limb recovery. Data from a total of 52 patients were identified and categorized into two groups based on the specific rehabilitation protocols they received during their hospitalization: a study group and a control group. Both groups underwent individualized rehabilitation, differing only in the type of electrotherapy applied: the study group received functional electrical stimulation (FES) and shock wave therapy (RSWT), while the control group received conventional electrical stimulation. Results: After adjusting for baseline differences in severity and time since stroke, patients in the study group demonstrated a significantly greater improvement in functional parameters compared to the control group. The results show us a significant improvement of functionality after RSWT and FES in the study group, with values from 0.28 ± 0.28 to 0.99 ± 0.36 (p-value < 0.001) regarding Hand Grip, suggesting that the treatment effect persists even when initial clinical advantages in the control group are accounted for. Muscle force increased from 0.39 ± 0.54 to 7.67 ± 3.89, p-value < 0.001. Conclusions: The combined application of functional electrical stimulation and shock wave therapy, as modern rehabilitation interventions, provided additional benefits in upper-limb and prehension rehabilitation compared to classical electrical stimulation alone. Our findings suggest that the combined application of RSWT and FES is strongly associated with improved upper-limb recovery, even after adjusting for baseline clinical imbalances. While these results support the integration of these modern techniques into stroke protocols, further prospective randomized controlled trials are needed to confirm the definitive treatment advantage over conventional methods. Full article

Background/Objectives: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a multifactorial condition often refractory to standard medical therapy. Low-intensity extracorporeal shock wave therapy (Li-ESWT) is a mechanism-oriented option; however, prior reviews reported substantial heterogeneity, potentially due to pooling different wave-generator modalities despite their distinct physical properties. This study synthesized randomized evidence on Li-ESWT for CP/CPPS and explored a wave-generator modality as a prespecified effect modifier. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 2015 to 31 October 2025 (date of last search) for randomized controlled trials (INPLASY: 2025120064). Eligible studies compared Li-ESWT (focused, radial, or multifocal) with sham or standard medical therapy (SMT). The primary outcome was total NIH-CPSI at the follow-up closest to 12 weeks. Pooled effects were calculated as weighted mean differences (WMDs) with 95% confidence intervals (CIs). Prespecified subgroup analyses were performed by wave-generator modality and therapy strategy (monotherapy vs add-on to SMT). Results: Eight RCTs (n = 455) were included. Li-ESWT significantly improved total NIH-CPSI versus the control (WMD −8.46; 95% CI −12.12 to −4.79; I² = 94.8%). Benefits were observed in both monotherapy and the add-on to SMT trials. By modality, focused devices showed consistent effects (WMD −6.59; I² = 0.0%), whereas radial devices showed an imprecise estimate with extreme heterogeneity (WMD −10.38; 95% CI −21.33 to +0.57; I² = 98.2%). Multifocal devices showed a significant benefit (WMD −10.84; I² = 81.0%). Improvements were mainly driven by pain-domain reduction. Conclusions: Li-ESWT provides clinically meaningful symptom relief in CP/CPPS, predominantly through pain reduction. Modality- and strategy-based subgroup findings are exploratory given substantial heterogeneity, limited trials, and no head-to-head comparisons; focused devices showed consistent effects, whereas estimates for radial and multifocal devices warrant cautious interpretation. Full article

Background/Objectives: Septic shock involves severe circulatory and microcirculatory dysfunction and often requires vasopressors to maintain adequate mean arterial pressure (MAP). Conventional monitoring mainly reflects macrocirculation and may not capture changes in vascular tone or microcirculation. Remote photoplethysmography (rPPG) is a contactless optical method that analyzes peripheral pulse waveforms and may offer additional physiological insight during vasopressor therapy. The aim of this study was to assess the feasibility of rPPG for detecting pulse waveform changes associated with norepinephrine administration in septic shock. Methods: Prospective case series included three adult patients (n = 3) with septic shock admitted to the intensive care unit at Pauls Stradins Clinical University Hospital, Riga, Latvia. All patients received standard sepsis treatment, including fluid resuscitation and titrated norepinephrine to maintain MAP ≥ 65 mmHg. Continuous invasive arterial pressure monitoring was performed alongside rPPG signal acquisition from the palmar skin surface under controlled lighting. From averaged rPPG waveforms, perfusion index (PI), dicrotic notch amplitude (c-wave), and diastolic wave amplitude (d-wave) were extracted. Correlations between norepinephrine dose, MAP, and rPPG parameters were explored. Results: Increasing norepinephrine doses were associated with higher MAP and PI in all patients. Dicrotic notch and diastolic wave amplitude decreased consistently. These changes occurred alongside macrocirculatory stabilization and are consistent with increased vascular tone and altered arterial compliance. Conclusions: rPPG demonstrated feasibility for detecting pulse waveform changes during norepinephrine therapy in septic shock; however, larger controlled studies are required for validation. Full article

Background/Objectives: The objective of this systematic review was to identify and analyze the available evidence on the indications and contraindications of physical and manual therapies in cancer survivors, including patients with metastatic disease and those with a history of neoplasia in follow-up. Methods: A literature search covering the period from 2017 to 2025 was conducted using the following databases: PubMed, NICE, NHS Evidence, PEDro, MEDLINE, and ScienceDirect. Systematic reviews and meta-analyses investigating manual or instrumental physiotherapy interventions in cancer survivors were identified and analyzed according to the PRISMA checklist. Results: Of the initial 2232 studies retrieved across the databases, 9 studies met the inclusion criteria. The available evidence suggests a positive effect of physiotherapy interventions on pain reduction in cancer survivors, both during and after chemotherapy. Conclusions: The clinical recommendation is to implement instrumental physical therapies and manual therapy as part of a multimodal approach rather than as isolated interventions. Close collaboration with the treating oncologist is recommended to determine whether the tumor type requires treatment to be performed away from the tumor site. No absolute contraindications to physiotherapy were identified, either during or after chemotherapy, including in patients with metastatic disease. Full article

Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled trial, 60 adults with MRI-confirmed NT-RCTT were assigned (1:1) to rESWT (one session weekly for six weeks; 2000 impulses per session, 2 bar air pressure, positive energy flux density 0.08 mJ/mm²; 8 impulses per second) or a multimodal PTM program (interferential current, shortwave diathermy and magnetothermal therapy; five sessions weekly for six weeks). All participants performed standardized home exercises. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) total score; secondary outcomes included pain (visual analog scale, VAS), satisfaction, range of motion (ROM), supraspinatus tendon (ST) thickness and acromiohumeral distance (AHD). Assessments were conducted at baseline, and at week 6 (W6) and week 12 (W12) post-baseline. Results: Both interventions significantly improved all outcomes, but rESWT produced greater and faster effects. Mean ASES total scores increased by 31 ± 5 points with rESWT versus 26 ± 6 with PTMs (p < 0.05). VAS pain decreased from 5.2 ± 0.7 to 1.0 ± 0.7 with rESWT and from 5.2 ± 0.8 to 1.7 ± 0.8 with PTMs (p < 0.01). rESWT achieved higher satisfaction and larger gains in abduction, flexion and external rotation. Ultrasound showed reduced ST thickness and increased AHD after rESWT but not after PTMs. No serious adverse events occurred. Conclusions: rESWT yielded superior pain relief, functional recovery and tendon remodeling compared with a multimodal PTM program, with markedly lower treatment time and excellent tolerability. Full article

Background/Objectives: Chronic ulcers are often characterized by impaired microcirculation, delayed epithelialization, and persistent pain. Extracorporeal shock wave therapy (ESWT) has emerged as a regenerative approach capable of modulating angiogenesis and tissue repair. This study aimed to evaluate the effects of ESWT on wound healing, microvascular remodeling, sensory recovery, and joint mobility in patients with chronic ulcerative lesions. Methods: In this prospective observational study, patients with chronic ulcers underwent a standardized ESWT protocol in addition to conventional wound care. Clinical outcomes were assessed at baseline and at the end of follow-up using the Bates–Jensen Wound Assessment Tool (BWAT), pain visual analogue scale (VAS), capillaroscopy, Semmes–Weinstein monofilament test (SWMT), two-point discrimination (2PD), and range of motion (ROM). Results: ESWT was associated with a significant improvement in wound status, pain, sensory function, and ROM. Capillaroscopy showed robust correlations with clinical recovery, inversely with BWAT (ρ = −0.64, p < 0.01), SWMT (ρ = −0.55, p < 0.05), and 2PD (ρ = −0.49, p < 0.05), and positively with ROM recovery (ρ = 0.58, p < 0.01). Diabetic and smoking patients required a longer healing period (5.8 ± 1.3 weeks) than non-diabetic, non-smoking patients (4.2 ± 0.9 weeks, p = 0.03), although BWAT, capillaroscopy, and ROM values converged by week 8. Conclusions: ESWT was associated with meaningful structural, microvascular, and functional improvements in chronic ulcers. Microvascular remodeling, assessed by capillaroscopy, emerged as a key correlate of clinical recovery. Despite slower early healing in diabetic and smoking patients, final regenerative outcomes were ultimately comparable across risk profiles. Full article

Hallux sesamoid pain arises from various pathological conditions, such as fracture nonunion, painful plantar keratosis, sesamoiditis, and avascular necrosis. Traditionally, sesamoidectomy is the primary surgical approach for these conditions, but its outcomes are inconsistent. In recent years, extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP) have gained popularity as effective conservative treatments in orthopedic practice. This review explored treatment approaches that avoid sesamoidectomy. First, we examined studies on ESWT and PRP for hallux sesamoid pathologies. We also reviewed research on ESWT and PRP for other foot conditions with similar characteristics to evaluate whether these treatments could be applicable to different types of sesamoid pathologies. Finally, we discussed surgical alternatives to sesamoidectomy and introduced several novel techniques. Full article