Ultrasound-Guided Lavage vs. Sham for Calcific Shoulder Tendinopathy .
Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study.
BMJ. 2023 Oct 11:383:e076447.Two hundred twenty patients with calcific tendinopathy of the shoulder persisting for at least three months were randomized to receive ultrasound-guided deposit lavage with corticosteroid injection (n=73), sham lavage with corticosteroid injection (n=74), or sham lavage with lidocaine only (n=73). The primary outcome of interest was the Oxford Shoulder Score (OSS) at four months. Secondary outcomes included QuickDASH scores, pain intensity, and radiographic changes in deposit appearance, assessed up to 24 months. Overall, the study found no significant difference in OSS improvement at four months between the treatment groups: lavage + steroid vs. sham, sham lavage + steroid vs. sham, and lavage + steroid vs. sham lavage + steroid. At 24 months, none of the study procedures were superior to sham. The findings suggest that neither ultrasound-guided lavage nor corticosteroid injection provides a clinically meaningful benefit over sham treatment for calcific tendinopathy of the shoulder.
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