Osteoarthritis (OA) is the leading musculoskeletal disease that disrupting quality of life. ESWT has been regarded as promising noninvasive OA management. This study aims to assess how ESWT affects OA patient’s cartilage degradation using urinary C-terminal crosslinking telopeptide of type II collagen (uCTX-II) biomarker. Thirteen OA patients were selected in this one-group pretest-posttest design. Each participant received ESWT intervention once a week for six weeks. Piezo Shockwave 2 (focused-ESWT) machine with an intensity 0.27 mJ/mm2, frequency 4 mHz, and total impulse 4000 shocks was used. Cartilage degradation was evaluated by uCTX-II before therapy (T1), at three weeks (T2) and six weeks after completing serial intervention (T3). uCTX-II results improved significantly during T2 (p=0.000) and got the peak at T3 compared to before treatment (p=0.001). Repeated measure test using general linier model demonstrated significant gradual pain reduction (p=0.00). Pearson correlation test revealed that pain scale (WBS) was highly associated with uCTX-II baseline result (p=0.002, r=0.781). ESWT is an effective and safe intervention allowing knee pain reduction and improvement in OA cartilage degradation.

Original languageEnglish
Pages (from-to)665-674
Number of pages10
JournalJournal of Medicinal and Pharmaceutical Chemistry Research
Issue number5
Publication statusPublished - May 2024


  • ESWT
  • Osteoarthritis
  • chronic disease
  • rehabilitation
  • uCTX-II


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