[The value of physical therapy modalities for osteonecrosis and bone marrow edema : Current study situation and practical applicability in everyday clinical practice].

Abstract

Physical therapy modalities play an essential role in the treatment of osteonecrosis and bone marrow edema. In addition to an accurate diagnosis, it is essential to understand the pathogenesis of the disease in order to define relevant physiological, cellular and biochemical targets. After careful consideration of efficacy and side effects, these therapies can be used both as adjunctive measures and as stand-alone treatments to prevent disease progression. In particular, shock wave and magnetic field therapies show promising results both clinically and in ongoing trials. In addition, in the acute phase, a targeted unloading phase may be helpful to reduce mechanical pressure on bone tissue. Interdisciplinary treatment planning and patient compliance are of similar importance.