Orthopaedics

Wear in the foot, knee or hip joints can have various causes: long-term overload from excess weight or work, malalignment, post-traumatic, genetic or metabolic causes. In all cases there is increased cartilage abrasion in the joint surfaces and remodelling of the subchondral bone.

As long as there is no extensive cartilage damage, stochastic resonance therapy can complement treatment – for example as a movement stimulus where osteoporosis is also present. Type and scope are determined by the treating physician.

The unpredictable stimuli trigger involuntary muscle activation and address the interplay of different muscle groups. Field observations describe a reduction in pain; combination with heat therapy is conceivable.

Stimulating the receptor systems triggers reflex activation; neural cell assemblies are trained independently of voluntary motor control. The unpredictability of the movements also generates high cerebellar activity, improving movement confidence and the timing of movement sequences.

The therapy is used for hip, femoral neck, lower leg and foot fractures as well as knee joint and patellar fractures, among others.

Prerequisites are full weight-bearing and existing callus formation. The mechanical stimuli are intended to stimulate bone formation and train muscle control; field observations describe a more favourable course.

With longer-term use it can also support bone metabolism and gait stability in older people.

Here the therapy pursues three goals: improving movement function by mobilising the capsule-ligament apparatus, “running-in mechanisms” at the edge of the resected meniscus cartilage, and strengthening and regenerating the mostly traumatically altered joint cartilage around the lesion.

Stochastic resonance therapy can complement rehabilitation after surgery. It is carried out two to three times a week over four weeks; from the second week the first cycles can be performed standing sideways on the platforms.

Treatment can begin just a few days after surgery — naturally at the lowest intensity and with the knee flexed (more than 10–15°). Depending on the location of the rupture, positioning is varied so the therapy remains pain-free; intensity can then be increased. Overall, healing time is shortened significantly.

Hip replacements are implanted for painful coxarthrosis and for traumatic, osteoporotic or tumour-related fractures; knee replacements for osteoarthritis, fractures or tumours. Stochastic resonance therapy is used with both cemented and cementless implants.

The mechanical stimuli are intended to stimulate bone formation – including where osteoporosis is also present. Pain-free application and regular X-ray checks are important.

With cemented implants, therapy can start about 14 days after surgery — at very low intensity with slow progression over six weeks, then once weekly for a further six weeks. With cementless implants, therapy usually starts five to six weeks after surgery, again gently and with slow progression to medium intensity.

Stochastic resonance therapy is an essential part of the overall therapy determined by the treating physician, which also addresses common accompanying conditions such as inactivity-related trunk muscle atrophy.

The mechanical stimuli are intended to stimulate bone formation and train the trunk muscles. Spinal X-rays and bone density measurement are prerequisites; changes in bone density can be measured after 6 to 12 months at the earliest.

The application is intended to gradually train mobility and load capacity after surgery and can thus support rehabilitation.

Load stability is expected around six weeks after surgery. Since the ligaments are not under significant tension in normal standing, therapy can start three weeks post-op — two to three times a week at low intensity. The affected side can initially be partially loaded; from week seven the first and second cycles can be done standing crosswise on the plates.