AAOS 2017: Management of rotator cuff calcific tendinitis with needling, lavage and CS

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
48 patients with calcific tendinitis of the rotator cuff were included in this randomized controlled trial to compared the clinical and radiographic outcomes of ultrasound-guided barbotage (needling and lavage) combined with an ultrasound-guided corticosteroid injection in the subacromial bursa (SAI) to an ultrasound-guided corticosteroid injection in the subacromial bursa alone. At 5 years, while both groups demonstrated significant improvements from baseline in clinical and resorption outcomes, there were no significant differences between groups. These results were Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Calcific tendinitis of the rotator cuff is a common cause of shoulder pain. There are a multitude of management options for this condition; however, there is a paucity of high-quality clinical trials providing a long-term comparison between treatment options. This abstract was a 5-year follow-up of a previous trial that evaluated ultrasound-guided barbotage combined with an ultrasound-guided corticosteroid injection in the subacromial bursa in comparison to an ultrasound-guided corticosteroid injection in the subacromial bursa without barbotage.
What was the principal research question?
In patients with calcific tendinitis of the rotator cuff, are there any significant differences in long-term clinical and radiographic outcomes between treatment with ultrasound-guided barbotage combined with an ultrasound-guided corticosteroid injection in the subacromial bursa and treatment with isolated administration of an ultrasound-guided corticosteroid injection in the subacromial bursa only?
Population: 48 patients with calcific tendinitis of the rotator cuff.
Intervention: Barbotage+SAI group: Patients underwent ultrasound-guided barbotage (needling and lavage) combined with an ultrasound-guided corticosteroid injection in the subacromial bursa.
Comparison: SAI group: Patients received an isolated ultrasound-guided corticosteroid injection in the subacromial bursa.
Outcomes: The primary outcome was the Constant Shoulder Score (CS). Secondary outcomes included the Western Ontario Rotator Cuff Index (WORC), the Disabilities of the Arm, Shoulder and Hand score (DASH), radiographic characteristics (Gartner classification, size, affected tendon), and the incidence of rotator cuff tear (assessed with radiographs and ultrasound evaluation).
Methods: RCT
Time: Outcomes were assessed at 6 weeks, 3, 6, 12, and 60 months
What were the important findings?
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How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.