The Case that proved the concept: why MFAT is unique among orthobiologics

When I was first introduced to extracorporeal shockwave therapy (ESWT), I was very skeptical. I had had multiple vendors at multiple conferences explain the proposed mechanism of action, clinical indications, and some summary of the limited data available. I had tried the machines out on myself, yet for someone who was not having an MSK issue at the time, obviously the results were equivocal. It was hard for me to justify the cost of the device and I just wasn’t sure how I was going to implement it clinically.

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Fast forward a couple of years and I started working with an ESWT thought leader. He had a lot of confidence in ESWT and recommended it for almost all of his patients, especially those who were receiving orthobiologic treatments. I would follow these patients, and without true outcomes measures, it was hard to know how much if any ESWT was adding to successful outcomes and satisfied patients. I had tried it on several of my patients, and was not particularly impressed. I’m used to reliable and reproducibly good outcomes using orthobiologic injections–no need for the wild card of ESWT. Looking back, I think the reason it did not work as well as I had expected was patient selection. Once I figured out which patients and conditions are more likely to have success with ESWT, I started having more and more satisfied patients and good outcomes.

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While the evidence base and implementation of ESWT is gaining, it still is a bit of trial and error. Everyone says that plantar fasciosis is a slam dunk with ESWT. That has not been my experience. It is more nuanced. I can help you accelerate your learning curve so that you don’t make the same mistakes that I did and can pick the right patients sooner.

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ESWT is an attractive modality to add as a service and can quickly generate value. There are multiple manufacturers with devices at different price points, and I have clinical experience with most of them. I can help you choose the right device to meet your needs (I do not have any financial connection with any of these devices). This therapy can be administered by a technician (i.e. you don’t have to be the person spending time applying the therapy, sessions usually lasting 20 minutes), is a cash pay service, can deliver reliably good outcomes, and is a great augmentation for orthobiologic therapies.

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