Comparable Midterm Outcomes for Ultrasound-Guided Needling Versus High-Energy Shockwave Therapy for Rotator Cuff Calcific Tendinitis: A Randomized Controlled Trial.
Dominic M van Noort, Jan K G Louwerens, Inger N Sierevelt et al.
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In 30 seconds
This follow-up of a Level II randomized controlled trial compared 4 sessions of high-energy extracorporeal shockwave therapy (ESWT) with a single ultrasound-guided needling procedure (UGN) for symptomatic rotator cuff calcific tendinitis persisting despite nonoperative care. Of 82 originally allocated patients, 67 were included at a minimum of 5 years’ follow-up. Mean 5-year Constant-Murley Scores were 94.4 ± 6.4 with ESWT and 93.3 ± 13.6 with UGN (P = .67); 94% in each group reached the score’s minimal clinically important difference threshold. No significant between-group differences were reported.
Key findings
- At 5 years, mean Constant-Murley Scores were 94.4 ± 6.4 for ESWT and 93.3 ± 13.6 for UGN (P = .67).
- Ninety-four percent of patients in each group achieved the minimal clinically important difference threshold for the Constant-Murley Score.
- Additional treatment was received by 42% of ESWT patients and 26% of UGN patients (P = .17).
- No treated-tendon deposit recurrence was found; new deposits in a different rotator cuff tendon occurred in 15% of UGN patients.
Why it matters
Both approaches were associated with high midterm shoulder-function scores, and most patients in each group reached a clinically important improvement threshold. The findings provide comparative long-term outcome information for two procedures used after nonoperative treatment has not resolved symptomatic calcific tendinitis, while also showing that further treatment was common in both groups.
What to keep in mind
Only 67 of the 82 originally allocated patients were included at follow-up. The authors note that high rates of additional treatment may have left the between-group analysis underpowered.