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Rotator Cuff Calcific Tendonitis: Short-term and 10-year Outcomes after Two-Needle US-guided Percutaneous Treatment— Nonrandomized Controlled Trial

Authors: Giovanni Serafini, Luca M. Sconfienza, Francesca Lacelli, Enzo Silvestri, Alberto Aliprandi, and Francesco Sardanelli

References: Radiology 2009 252: 157-164

Purpose: To compare short- and long-term outcomes of patients with rotator cuff calcific tendonitis who did and did not undergo ultrasonographically (US)-guided percutaneous treatment.

Materials and Methods: Institutional review board approval and informed patient consent were obtained. Of patients referred for US-guided treatment of rotator cuff calcific tendonitis, 219 (86 men, 133 women; mean age, 40.3 years ± 10.9 [standard deviation]) were treated; 68 (31 men, 37 women; mean age, 40.2 years ± 11.3) patients refused treatment and served as control subjects. After local anesthesia was induced, two 16-gauge needles were inserted into the calcific deposit. Saline solution was injected through one needle, and the dissolved calcium was extracted through the other needle. Shoulder joint function was assessed by using Constant scores, and pain was assessed by using visual analogue scale (VAS) scores. Mann-Whitney U and 2 tests were performed.

Results: At baseline, no significant difference in age or sex distribution, Constant score, or VAS score was detected between treated and nontreated (control) patients. Compared with control subjects, treated patients reported a significant decrease in symptoms at 1 month (mean Constant score, 73.2 ± 6.2 vs 57.5 ± 3.9; mean VAS score, 4.8 ± 0.6 vs 9.1 ± 0.5), 3 months (mean Constant score, 90.2 ± 2.6 vs 62.6 ± 7.2; mean VAS score, 3.3 ± 0.4 vs 7.3 ± 1.8), and 1 year (mean Constant score, 91.7 ± 3.1 vs 78.4 ± 9.5; mean VAS score, 2.7 ± 0.5 vs 4.5 ± 0.9) (P < .001). Symptom scores were not significantly different between the groups at 5 years (mean Constant score, 90.9 ± 3.6 vs 90.5 ± 4.8; mean VAS score, 2.6 ± 0.5 vs 2.8 ± 0.7) (P  .795) and 10 years (mean Constant score, 91.8 ± 5.0 vs 91.3 ± 9.6; mean VAS score, 2.5 ± 0.6 vs 2.7 ± 0.6) (P  .413).

Conclusion: US-guided percutaneous treatment facilitated prompt shoulder function recovery and pain relief. Treated patients had better outcomes than did nontreated patients at 1 year. However, 5 and 10 years after the procedure, the nontreated group reported outcomes similar to those of the treated group.

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