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Shock-wave therapy machine brings new treatment option

October 13, 2002

A new veterinary treatment machine which uses shock-wave therapy has been brought to New Zealand by a Canterbury veterinarian. The VersaTron is the first machine of its type in use in New Zealand and is used to treat bone and soft-tissue injuries by focusing electrohydraulically generated shock waves on the affected area.

The technology behind the VersaTron has been developed over a period of about 20 years, but there are only a handful of similar machines in Australasia, and this is the first VersaTron in New Zealand.

Dr Shri Kanth treats a standardbred mare with arthritis of the knee. The probe is kept moving at all times, and the leg is placed in several positions during treatment.

A horse with sesamoiditis and calcification of the suspensory ligament undergoes treatment with the VersaTron.

A thoroughbred gelding who bowed his tendon four months ago is treated by Dr Kanth. The VersaTron is widely used to treat such injuries and in many cases the injury is barely visible after treatment.

Several positions, and probes of different ranges, are used on each patient. Here, a bowed tendon is treated. The vet or practitioner operates the probe with a foot pedal.

This treatment method is nothing new - it has been in use since the 1980s to treat conditions in humans such as kidney stones. Made by Swiss company HMT, the VersaTron is widely used in Europe and features a greater focal size (6.9 x 40.5mm) and area (37.4mm2) than similar devices. The Canterbury veterinarian who bought the unit first saw the VersaTron in use two years ago, and earlier this year tested a trial unit for about three weeks before deciding to buy a new machine for his practice.

The machine uses a series of electrohydraulically generated shock waves, which pulse into the injured area to relieve pain and reduce inflammation. Treatment can take as little as 10 minutes, and in general only about 500 to 1000 shocks are required for a treatment. There are four sizes of probes that can be used, and each works to a specific depth, with the greatest working to a depth of 12-15cm. To the human finger, the shockwave feels like a concentrated shock from an electric fence. It sounds similar to a cap gun being fired repeatedly.

In horses, the area to be treated must be shaved, cleaned with alcohol, and coupling gel applied, and the animal needs a mild sedative.

Dr Shri Kanth, DVM, who has been using the VersaTron for several years at the Selangor Turf Club Equine Hospital in Kuala Lumpur, Malaysia, says the machine combines an analgesic effect with a reduction in inflammation and an improvement in bone formation and and increase in blood circulation. However, it is not suited for use on an injury in the acute stages, when there is a high degree of inflammation. "It is important to know when to initiate the treatment," he says.

It can be used all over the horse, but is most commonly used to treat tendon, sesamoid and ligament damage, as well as the initial stages of arthritis, osteoporosis, stress fractures, navicular and sacro-iliac conditions. Trials currently under way by Dr Kanth include those on cervical spine facet joint arthritis, pedal bone injuries, and sclerosis of the third carparl bone.

What makes the VersaTron different from other treatment devices is that it delivers a single acoustic pulse with an extremely short rise time and with a high pressure in a short pulse duration.

Both veterinarians stress that the VersaTron is not a miracle cure, but another treatment method to be used in conjunction with conventional treatments. "In the past three years we've seen tremendous results," Dr Kanth says, "but the right diagnosis is the main thing, then treatment, then after-care."

The time between treatments is also crucial, Dr Kanth says. "If the treatment interval is too short you can increase the inflammation."

The Canterbury veterinarian will be using the machine for a range of conditions. "It's pretty well proven in most conditions, not all, but most. The conditions it will cure most will be the ones we see the most - shin soreness, sesamoiditis, and so on. The trouble with shin soreness is, they go out for a spell, bring them back again, and they go sore again. This can shorten that period down so that they hopefully won't go sore again," he said.

Old injuries can also benefit from the treatment, he says. "It depends what the injury is. It can be helpful for old suspensory ligament problems and old tendon injuries. If it has gone too far and the arthritis is too bad, then it could well help that, because it's going to start a new healing process."

It is also possible for the likes of a bowed tendon to return to looking normal after treatment. "One we did with the trial machine has now almost completely disappeared. The horse is working now quite normally, and is quite sound."

A colleague in Auckland using a similar machine has cut his number of surgical cases down by more than half.

The machine cost "much nearer six figures than five figures", and an average treatment will cost about $300 plus sedation, but the veterinarian says much of that is to cover the equipment costs. "After 50,000 shocks the probes must go back to Switzerland to be refurbished, at a cost of about $2500 each time." An average treatment will take about 1000 shocks.

He said he had not taken the move to high technology lightly. "I'm usually very conservative, I'm not a great fan of lasers, for example, though I know they do work with some horses. But I've done a lot of research into the VersaTron and have spoken to many people who use them -- and they are reporting an 80% success rate with most conditions. So it's going to help most conditions."

Using the DolorClast machine, which is not a focused machine but a radial treatment. The generation of shock waves is different than the VersaTron, but the principle of treatment is the same.



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