Extracorporeal Shock Wave Therapy for the Treatment of Chronic Calcifying Tendonitis of the Rotator Cuff

Abstract

ALCIFIC TENDONITIS OF THErotator cuff is a well-known source of shoulder pain. 1 Estimates of the overall incidence vary widely, ranging between 2.5% and 20%, 1-3 depending on both clinical criteria and radiographic technique. The disease is usually selflimiting but the natural course is variable. [1][2][3][4][5] For instance, Gärtner 6 reported that calcifications with sharp margins and homogeneous or nonhomogeneous structure disappeared spontaneously in 33% of patients over a period of 3 years, but that 85% of fluffy accumulations did so during the same time period. In 1941, Bosworth 1 reported that 6.4% of calcific lesions showed spontaneous resorption.Clinically, it is important to distinguish calcific tendonitis from a rotator cuff tear as a source of shoulder pain. 7 Several authors have found no correlation between the presence of a tendon tear and calcific tendonitis. 4,[7][8][9][10] The treatment of patients with calcific tendonitis typically is conservative, including use of subacromial cortisone injections, physical therapy, Author Affiliations are listed at the end of this article.

High-energy Versus Low-energy Extracorporeal Shock Wave Therapy for Calcifying Tendinitis of the Shoulder: Which is Superior? A Meta-analysis

“…has few adverse events and minor side effects such as bruising and hematoma often are short-lived [9,22]. Two cases of humeral head osteonecrosis have been reported [6].…”

“…The high-quality studies were those of Albert et al [1], Gerdesmeyer et al [9], and Pleiner et al [21]. The lowquality studies were those of Loew et al [17] and Rompe et al [22].…”

“…Gerdesmeyer et al [9] described the change in calcification in actual mm 2 decrease, thus we did not include this article in the quantitative analysis.…”

“…In the supraspinatus tendon, the most affected location is 1.5 to 2.0 cm away from its insertion at the greater tuberosity [5,8,11,23]. The etiology of the calcium deposits in the rotator cuff is disputed [9,20,23]. It has been suggested that it is related to decreased local oxygen tension or hypoxia [5,8].…”

“…This is why it often is done in an inpatient setting. Low-energy ESWT, on the contrary, usually is performed in an outpatient setting by a physical therapist [1,9].…”