You know that your role in the healing process is just as critical to patient success as the surgery itself. Your surgical partners trust you to be up to date on the latest in rehabilitative care. That includes regenerative solutions. Your ability to provide evidence-based protocols that improve post-surgical outcomes is crucial to not only to patient success but to the success of your partner relationships. Your surgical teams need to know that you’re on the cutting edge of technology and patient care. Your success in helping patients heal post-surgery is an extension of their success in the operating room.

Shockwave therapy has long been regarded as complementary to surgical procedures, and now, the largest study of its kind offers additional evidence that the therapy improves post-operative patient outcomes.

The Study: A Groundbreaking Pilot

A new pilot study published in the Journal of Orthopaedic Surgery and Research offers compelling preliminary evidence for the use of Extracorporeal Shockwave Therapy (ESWT) in combination with Electromagnetic Transduction Therapy (EMTT) to improve bone healing in selective foot and ankle surgeries.

As the largest case-control series published to date, the results are more than promising for patients and practitioners alike. The study’s findings could drastically change post-operative care for the better through the use of ESWT and EMTT within the first few weeks of recovery.

Study Rationale & Design

Knowing that the delayed union or non-union of bones poses a significant challenge in foot and ankle surgeries, researchers sought to determine if a combined protocol of ESWT and EMTT could:

  • Improve radiographic bone healing compared to standard post-operative care.
  • Enhance pain management.
  • Hasten the patient’s return to activity.

Patient Matching:

  • Researchers matched 10 control patients (standard care) with 10 intervention patients using “best neighbor” practices.
  • All patients underwent one of the following surgeries:
    • Talar osteochondral defect repair
    • Foot and ankle fracture repair
    • Lapidus or Ludloff bunionectomy

Exclusion Criteria: Patients were excluded from participation if they had a history of:

  • Current tobacco use
  • Diabetes
  • Rheumatological or immunodeficiency disorders
  • Revision surgery
  • Worker’s Compensation/Industrial cases

The Intervention Protocol

The intervention group received a specific non-invasive treatment protocol within three weeks post-operation:

  • 1 session of focused ESWT
    • Applied up to 0.35 mJ/mm² to the surgical site.
  • 2 sessions of EMTT
    • Set at 6000 pulses each, power level 8, and 8 Hz.
    • One ESWT session was applied on the same day as one of the EMTT sessions.

All other aspects of post-operative care were identical between the control and intervention groups.

Key Findings & Results

Researchers found that in all three measured categories, the intervention group significantly out-performed the control group.

  •  Lower Post-Operative Pain: Patients reported significantly reduced pain scores (VAS).
  •  Faster Return to Activity: Patients returned to daily activities sooner.
  • Accelerated Radiographic Healing: Exhibited more signs of bone healing at the 4-week mark via X-ray.
  • High Patient Tolerance: The protocol was well tolerated with minimal side effects.

The study supports what we’ve known for years. Integrating ESWT and EMTT into your postoperative care plans is a non-invasive, easy way to dramatically improve patient health outcomes and satisfaction levels, sending patients on the road to recovery faster and safely.

Why This Matters for Post-Operative Care and Your Provider Partnerships

These findings have powerful implications for integrating ESWT and EMTT into standard post-operative care plans.

  • Pain Management: The dramatic reduction in VAS scores indicates a potent analgesic effect, potentially reducing reliance on opioid medications.
  • Functional Recovery: Cutting the average return-to-activity time is a monumental improvement for patient quality of life and satisfaction.
  • Accelerated Healing: Significant improvement in early radiographic healing indicates enhanced osteogenesis and angiogenesis, directly targeting the risk of non-union.
  • Sociological & Economic Benefits: Reduced healing times lessen financial burdens on patients and the healthcare system, allowing for a quicker return to work and normal life.

Research results like these validate your modalities and provide the opportunity to expand your partnership network and relationships. Offering patient-forward solutions that reduce recovery time, decrease possible prescription pain medication reliance, and prevent the need for revision surgery, puts you at the forefront of rehabilitative care in the eyes of patients and providers alike. Partnering with surgery teams in the first few weeks of recovery is a win for patients and for you.

If you’re exploring how shockwave can support post-surgical outcomes within referral-based care, it helps to work with a partner who understands both the clinical application and the dynamics of surgical collaboration.  At Kinas Medical, we support clinicians who integrate ESWT and EMTT into surgical referral relationships, providing education, implementation guidance, and the resources designed to strengthen those partnerships. Call us today at 770.612.8245 or email info@kinasmedical.com. We can discuss how shockwave with Kinas Medical can help grow your practice within the surgical space, and how your peers are finding success within this space already!

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This blog post is based on the study: Saxena et al. (2025). Journal of Orthopaedic Surgery and Research. https://doi.org/10.1186/s13018-025-06420-9. Devices referenced: Duolith™ and Magnetolith™ by Storz Medical AG.**