Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder

Abstract

We report a prospective study of the effects of extracorporeal shock-wave therapy in 195 patients with chronic calcifying tendinitis. In part A 80 patients with chronic symptoms were randomly assigned to a control and three subgroups which had different treatment by low-energy and high-energy shock waves. In part B 115 patients had either one or two high-energy sessions. We recorded subjective, functional and radiological findings at six months after treatment. The results showed energy-dependent success, with relief of pain ranging from 5% in our control group up to 58% after two high-energy sessions. The Constant scores and the radiological disintegration of calcification were also dose-dependent. Shockwave therapy should be considered for chronic pain due to calcific tendinitis which is resistant to conservative treatment.

Radiologic course of the calcific deposits in calcific tendinitis of the shoulder: Does the initial radiologic aspect affect the final results?

“…9,10,17,18 In cases of ESWT, the elimination rate was also wide, with 15% to 70%, even though the rate of disintegration and resorption increased with higher levels of shock waves and longer periods of follow-up. 14,[22][23][24]29,33 On the other hand, in our previous study on arthroscopic treatment of calcific tendinitis, the deposits were completely removed in 72% of the shoulders studied. 21 In the present study, we observed that type I and type II deposits by the classification of Gartner and Simons changed to type II and type III over time in most of the shoulders.…”

“…NSAIDs therapy has been the main conservative method. Other methods include steroid injection, mild shoulder passive stretching exercises, ESWT, 14,15,24 and needle aspiration and lavage. We applied various conservative methods suitable to each patient.…”

“…6,19,20,28 In some patients, calcific deposit removal is through open 16,30 or arthroscopic 1,7 procedures, with varying results. Most recently, the result of extracorporeal shock-wave therapy (ESWT) 14,15,24 has been reported, but it still requires a longer-term follow up.…”

Shock Waves in the Treatment of Post-Traumatic Myositis Ossificans

“…Following investigators described calcifying tendinopathy as calcium deposits in necrotic collagen tissue (Tashjian et al 2009). Therefore, the application of shockwave therapy in calcified tendon induces an increased pressure within the therapeutic focus, causing fragmentation and cavitation inside the amorphic calcifications, leading to disorganisation and disintegration of these deposits (Loew et al 1999). This effect does not occur when there is lamellar bone organized in osteons in the target zone because there is too little space to generate cavitation (Russo et al 2000).…”

Calcifying tendinitis of the shoulder: Advances in imaging and management

“…Although more attention has been recently paid to ESWT, long-term results with the noninvasive treatment are currently no better than with surgery [21][22][23][24].…”