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Wissenschaftliche Studien zur Kalkschulter
- Details
- Geschrieben von Dr. Holger Groß
PM R. 2013 Mar;5(3):242-4. doi: 10.1016/j.pmrj.2013.01.007. Epub 2013 Feb 9.
A simple technique to restore needle patency during percutaneous lavage and aspiration of calcific rotator cuff tendinopathy.
Department of Physical Medicine & Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Sonography in the treatment of calcific tendinitis of the rotator cuff.
Source
Department of Radiology and Imaging, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA. Diese E-Mail-Adresse ist vor Spambots geschützt! Zur Anzeige muss JavaScript eingeschaltet sein!
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Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle-lavage technique.
Ultraschall Med. 2011 Jan;32 Suppl 1:S117-23. Epub 2010 Apr 22.
US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons.
De Zordo T, Ahmad N, Ødegaard F, Girtler MT, Jaschke W, Klauser AS, Chhem RK, Romagnoli C.
Source
Radiology, Medical University Innsbruck, Innsbruck, Austria. Diese E-Mail-Adresse ist vor Spambots geschützt! Zur Anzeige muss JavaScript eingeschaltet sein! "> Diese E-Mail-Adresse ist vor Spambots geschützt! Zur Anzeige muss JavaScript eingeschaltet sein!
Abstract
To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lavage using a two-needle technique with 16 - 18 G needles in the treatment of patients with calcific tendinopathy in the shoulder, elbow, hip, and knee by radiological and clinical follow-up.
A retrospective chart review was performed and 40 patients (13 male, 27 female; mean age, 53.5 years; range 24 -74 years) were identified as having received US-guided perforation and lavage due to symptomatic calcific tendinopathy of the rotator cuff tendons, triceps, extensor and flexor tendons at the elbow, rectus femoris tendon and patellar tendons. The radiographic outcome was assessed by comparison of the size and quality of the calcification before and 6 weeks after the procedure. On US images, the quality of the acoustic shadow was assessed, together with other alterations of the tendon and surrounding tissue. Patients were interviewed by telephone to assess the clinical outcome regarding pre-treatment and post-treatment pain and tendon function.
RESULTS:
34 shoulder tendons and 6 non-shoulder tendons were identified. The mean calcium reduction was 39.9 mm(2) (range, 0 - 215; p < 0.001), while 80 % of patient showed a resolution of more than 60 % resulting in good clinical improvement. A very low complication rate was found (1 partial tear).
CONCLUSION:
The US-guided perforation and lavage technique is an effective and safe treatment for rotator cuff calcifications as well as for other body tendons. Although the two-needle technique and large needles were used in this study, a very low complication rate was detected.
Calcific shoulder tendinitis: treatment with modified US-guided fine-needle technique.
Source
Department of Radiology, CHUM-Hôpital Saint-Luc, 1058 Saint-Denis, Montreal, Quebec, Canada H2X 3J4.
Abstract
To evaluate clinical response to treatment of calcified tendinitis of the shoulder by using a modified percutaneous ultrasonography (US)-guided fine-needle technique.
Thirty shoulders of 30 consecutive patients (23 women, seven men; mean age, 47.4 years) with chronic shoulder pain (average duration, 43.1 months) refractory to medical treatment were treated percutaneously by using a fine needle and US guidance. Patients were prospectively evaluated by using a shoulder pain and disability index consisting of 13 items and divided into two subcategories: pain and disability. The patient completed the questionnaire before the procedure and during the follow-up visit approximately 1 month later. A diagnostic US examination was also performed at that time.
RESULTS:
There was a statistically significant improvement in the shoulder pain and disability index total score (27.0%) and the pain (30.5%) and disability (23.9%) scores. According to the index, these results indicate a significant clinical response.
CONCLUSION:
This modified US-guided fine-needle technique for calcified tendinitis of the shoulder appears to be an effective therapy and was less aggressive than previously described percutaneous techniques.
Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results.
Source
Department of Radiology, Hospital de Basurto, Ave. Montevideo 18, 48013 Bilbao, Spain.
Abstract
The purpose of our study was to evaluate the short- and long-term effectiveness of sonographically guided percutaneous needle aspiration and lavage in calcific tendinitis of the shoulder and to study the progress of calcifications and symptoms in the first year after treatment.
MATERIALS AND METHODS:
Symptoms and radiologic findings after percutaneous aspiration of calcific tendinitis were prospectively evaluated in the short and the long term using a shoulder pain and disability index, evaluation of shoulder motion, and a survey of the self-perception by the patients regarding the progress of their disease.
RESULTS:
Sixty-seven consecutive shoulders were treated. A significant improvement was seen in shoulder motion, pain, and disability in the short term and in the long term (p < 0.0001). One year after treatment, 91% of shoulders had substantially or completely improved, 64% had perfect motion, and calcifications on radiography had resolved completely or nearly completely in 89%. A transitory recurrence was observed approximately 15 weeks after treatment in 44.3% of shoulders that improved.
CONCLUSION:
Percutaneous needle aspiration and lavage is effective in the short term and in the long term in calcific tendinitis of the shoulder, with results similar to or better than those published for other techniques, and it is only slightly invasive and painful. Progress after treatment may include a transitory period of recurrence of the pain.
Quelle:
Studien zur Stoßwellentherapie
Extracorporeal shock wave therapy in chronic calcific tendonitis of the shoulder--is it effective?
Source
Royal Surrey County Hospital, Guildford, Surrey, United Kingdom.
Abstract
Extracorporeal shock wave therapy has been claimed to be an effective non-invasive treatment for chronic calcific tendonitis of the supraspinatus tendon. However many trials have been criticised for not achieving necessary scientific standards. We report a prospective, single blinded, randomised control trial of 20 patients, which looked into effectiveness of the therapy. Subjectively, 45% of the treated patients were satisfied with the outcome and also had objectively increased their Constant score by 11% at 6 months. The control group experienced no subjective or objective improvement with p value < 0.03. This study confirms that extracorporeal shock wave therapy is effective in treating chronic calcific tendonitis when compared with a placebo group. However in our experience it is not as successful as previously claimed, with half the patients failing to achieve a satisfactory out come and requiring surgical excision. Patients found the procedure painful, which has not been previously alluded to.
High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial.
Source
Department of Rheumatology, Clinique Mutualiste La Sagesse, 4 place Saint Guenolè, 35043 Rennes Cedex, France. Diese E-Mail-Adresse ist vor Spambots geschützt! Zur Anzeige muss JavaScript eingeschaltet sein!
Abstract
In a prospective randomised trial of calcifying tendinitis of the rotator cuff, we compared the efficacy of dual treatment sessions delivering 2500 extracorporeal shock waves at either high- or low-energy, via an electromagnetic generator under fluoroscopic guidance. Patients were eligible for the study if they had more than a three-month history of calcifying tendinitis of the rotator cuff, with calcification measuring 10 mm or more in maximum dimension. The primary outcome measure was the change in the Constant and Murley Score. A total of 80 patients were enrolled (40 in each group), and were re-evaluated at a mean of 110 (41 to 255) days after treatment when the increase in Constant and Murley score was significantly greater (t-test, p = 0.026) in the high-energy treatment group than in the low-energy group. The improvement from the baseline level was significant in the high-energy group, with a mean gain of 12.5 (-20.7 to 47.5) points (p < 0.0001). The improvement was not significant in the low-energy group. Total or subtotal resorption of the calcification occurred in six patients (15%) in the high-energy group and in two patients (5%) in the low-energy group. High-energy shock-wave therapy significantly improves symptoms in refractory calcifying tendinitis of the shoulder after three months of follow-up, but the calcific deposit remains unchanged in size in the majority of patients.
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Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder.
Source
Departments of Orthopaedics and Radiology, China Medical University Hospital, Taichung, Taiwan.
