CHRONIC CALCIFYING TENDINITIS OF THE ROTATOR CUFF OF THE SHOULDER JOINT: SHOCK WAVE THERAPY AS THE METHOD OF CHOICE IN OUTPATIENT SETTINGS
DOI:
https://doi.org/10.32782/pub.health.2023.4.14Keywords:
calcifying tendinitis of the rotator cuff of the shoulder, extracorporeal shock wave therapyAbstract
Topicality. Calcifying tendinitis of the shoulder rotator cuff (CT RMP) is characterized by a large population prevalence and can remain resistant to conservative treatment for months. One of the promising directions is extracorporeal shock wave therapy, which today occupies a prominent place in the system of providing assistance to patients with pain syndromes of the musculoskeletal system. Materials and methods. An analytical review of literature sources in the PubMed database was carried out. The results. CT RMP is diagnosed in 10–42% of the population, primarily women aged 20–50 years, and is one of the main causes of chronic shoulder pain. The development of CT RMP passes through several clinical and pathogenetic stages: precalcification, calcification, and reparation. CT RMP is well diagnosed by X-ray or ultrasound examination. A number of treatment tactics have been proposed without evidence of the superiority of any particular one of them. The use of extracorporeal shock wave therapy (EUHT) in patients with severe and persistent symptoms of CT RMP is substantiated. It has been established that EUHT can significantly reduce pain, improve the function of the shoulder joint and quality of life, and reduce the size of calcification compared to conservative treatment methods. A number of systematic reviews and meta-analyses have shown that EUCT significantly improved Constant–Murley scores and pain intensity compared with other methods and/or placebo. It is shown that the high-energy EUHT protocol has advantages over the low-intensity protocol. Conclusions. Calcifying tendinitis of the rotator cuff of the shoulder (CT RMP) should be recognized as an actual pathology of the musculoskeletal system. The analysis of literature data shows the high efficiency of extracorporeal shock wave therapy (ECHT) for this pathology and the need to introduce this method into treatment protocols in outpatient settings.
References
Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment. F. Draghi et al. J. Ultrasound 2020. 23. 301–15. https://doi.org/10.1007/s40477-019-00393-2.
Della V., Emilio V., Bassi M. Migration of calcium deposits into subacromial–subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging. J. Ultrasound. 2015. 18. 259-263.
Imaging of calcific tendinopathy around the shoulder: usual and unusual presentations and common pitfalls. D. Albano et al. Radiol. Med. 2021. 126. 608–19. https://doi.org/10.1007/s11547-020-01300-0.
Darrieutort-Laffite C., Blanchard F., Le Goff B. Calcific tendonitis of the rotator cuff: from formation to resorption. Jt. Bone. Spine. 2018. 85. 687–92 https://doi.org/10.1016/j.jbspin.2017.10.004.
The value of musculoskeletal ultrasound in geriatric care and rehabilitation. B. Can et al. Int. J. Rehabil. Res. 2017. 40. 285–96.
Lui P.P.Y. Histopathological changes in tendinopathy-potential roles of BMPs? Rheumatol. 2013. 52. 2116-2126.
Rotator cuff calcific tendinopathy: from diagnosis to treatment. V. Chiancaet al. Acta Biomed. 2018. 89. 186-196.
Which method is more effective in treatment of calcific tendinitis in the shoulder? Prospective randomized comparison between ultrasound-guided needling and extracorporeal shock wave therapy. Y.S. Kim et al. J. Shoulder Elbow Surg. 2014. 23. 1640–6.
Merolla G., Bhat M. G., Paladini P., Porcellini G. Complications of calcific tendinitis of the shoulder: a concise review. J. Orthop. Traumatol. 2015. 16. 175–83. https://doi.org/10.1007/s10195-015-0339-x.
Louwerens J. K. G., Sierevelt I. N., van Noort A., van den Bekerom M. P. J. Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis. J Shoulder Elbow Surg 2014. 23. 1240–9. https://doi.org/10.1016/j.jse.2014.02.002.
Radiological and clinical predictors of long-term outcome in rotator cuff calcific tendinitis. P.B. De Witte et al. Eur Radiol 2016. 26. 3401–11.
Thankam F. G., Dilisio M. F., Gross R. M., Agrawal D. K. Collagen I: a kingpin for rotator cuff tendon pathology. Am J Transl Res 2018. 10. 3291–309.
Erickson J. L., Jagim A. R. Ultrasonic tenotomy and debridement for calcific tendinopathy of the shoulder: a pilot case series. J Prim Care Community Health 2020. 11. https://doi.org/10.1177/2150132720964665.
Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. L.M. Sconfienza et al. Eur Radiol 2018. 28. 338–51. https://doi.org/10.1007/s00330-018-5474-3.
Diagnosis of calcific tendonitis of the rotator cuff by using susceptibility-weighted MR imaging. D. Nörenberg et al. Radiology. 2016. 278. 475–84. https://10.1148/radiol.2015150034.10.1148/radiol.2015150034.
Wu Y.-C. C., Tsai W.-C. C., Tu Y.-K. K., Yu T.-Y. Y. Comparative effectiveness of nonoperative treatments for chronic calcific tendinitis of the shoulder: a systematic review and network meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2017. 98. 1678–92. e6. https://doi.org/10.1016/j.apmr.2017.02.030.
Devereaux M., Velanoski K. Q., Pennings A., Elmaraghy A. Short-term effectiveness of precut kinesiology tape versus an NSAID as adjuvant treatment to exercise for subacromial impingement: a randomized controlled trial. Clin J Sport Med 2016. 26. 24–32. https://doi.org/10.1097/jsm.0000000000000187.
Chronic calcific periarthritis of the elbow treated by cimetidine administration: five cases. H. Kimura et al. J Orthop Surg 2017. 25. https://doi.org/10.1177/2309499017717193.
Focused, radial and combined shock wave therapy in treatment of calcific shoulder tendinopathy. M. A. Abo Al-Khair et al. Phys Sportsmed 2021. 49. 480–7. https://doi.org/10.1080/00913847.2020.1856633.
Extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage, corticosteroid injection and combined treatment for the treatment of rotator cuff calcific tendinopathy: a network meta-analysis of RCTs. A. Arirachakaran et al. Eur J Orthop Surg Traumatol 2017. 27. 381–90. https://doi.org/10.1007/s00590-016-1839-y.
Focused extracorporeal shock wave therapy combined with supervised eccentric training for supraspinatus calcific tendinopathy. E. Carlisi et al. Eur J Phys Rehabil Med 2018. 54. 41–7. https://doi.org/10.23736/S1973-9087.16.04299-4.
The effects of scapular mobilization in patients with subacromial impingement syndrome: a randomized, doubleblind, placebo-controlled clinical trial. A. Aytar et al. J Sport Rehabil 2015. 24. 116–29. https://doi.org/10.1123/jsr.2013-0120.
Extracorporeal shockwaves therapy versus hyaluronic acid injection for the treatment of painful non-calcific rotator cuff tendinopathies: preliminary results. A. Frizziero et al. J Sports Med Phys Fitness 2017. 57. 1162–8. https://doi.org/10.23736/S0022-4707.16.06408-2.
Zhang T., Duan Y., Chen J., Chen X. Efficacy of ultrasound-guided percutaneous lavage for rotator cuff calcific tendinopathy: A systematic review and meta-analysis. Medicine 2019. 98 e15552.
Recovery pattern after arthroscopic treatment for calcific tendinitis of the shoulder. C.H. Cho et al. Rev Chir Orthop Traumatol 2020. 106. 395. https://doi.org/10.1016/j.otsr.2020.03.005.
Lee T.K., Shin S.J. Functional recovery of the shoulder after arthroscopic treatment for chronic calcific tendinitis. Clin Shoulder Elb 2018. 21. 75–81. https://doi.org/10.5397/cise.2018.21.2.75.
Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder. W.Y. Chou et al. Bone Jt J 2017;99B:1643–50. https://doi.org/10.1302/0301-620x.99b12.bjj-2016-1178.r1.
F Extracorporeal shockwaves versus ultrasound-guided percutaneous lavage for the treatment of rotator cuff calcific tendinopathy: a randomized controlled trial. Del Castillo-González et al. Eur J Phys Rehabil Med 2016. 52. 145–51.
Evaluation of arthroscopic rotator cuff repair results in patients with anterior greater tubercle cysts. M.H. Sahan et al. J Orthop Surg 2019. 27. 2309499019825602.
Reliability of magnetic resonance imaging in ratator cuff and biceps tendon pathologies. M.H. Sahan et al. J Clin Anal Med 2017;8suppl 4:310–5.
Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients S. Serbest et al.. Knee Surg Sports Traumatol Arthrosc 2017. 25:2109–13.
Comparative efficacy of nonoperative treatments for greater trochanteric pain syndrome: a systematic review and network meta-analysis of randomized controlled trials. A. Gazendam et al. Clin J Sport Med 2021. https://doi.org/10.1097/JSM.0000000000000924.
Extracorporeal shock-wave therapy for supraspinatus calcifying tendinitis: a randomized clinical trial comparing two different energy levels. F. Ioppolo et al. Phys Ther 2012. 92. 1376–85. https://doi.org/10.2522/ptj.20110252.
Arm position during extracorporeal shock wave therapy for calcifying tendinitis of the shoulder: a randomised study. D. Tornese et al. Clin. Rehabil., 25 (8) (2011), pp. 731-739, 10.1177/0269215510396740
Ultrasound guided needling vs radial shockwave therapy in calcific tendinitis of the shoulder: a prospective randomized trial. F.A. De Boer et al. J Orthop 2017. 14. 466–9.
Ultrasound-guided procedures to treat sport-related muscle injuries. D. Orlandi et al. Br J Radiol 2016. 89. 20150484.
