Elsevier

Journal of Shoulder and Elbow Surgery

Volume 11, Issue 5, September–October 2002, Pages 476-480
Journal of Shoulder and Elbow Surgery

Original article
Long-term effects of extracorporeal shockwave therapy in chronic calcific tendinitis of the shoulder*

https://doi.org/10.1067/mse.2002.126614Get rights and content

Abstract

Various short-term studies have demonstrated the effectiveness of extracorporeal shockwave therapy in the treatment of calcific tendinitis. To evaluate the long-term effects and any complications, the 4-year outcome was determined in a prospective study of 115 patients. One session (group A, n = 56) or two sessions (group B, n = 59) of high-energy shockwave therapy were administered to each patient. The 6-month results showed that the level of success achieved in pain relief and the Constant score was energy-dependent and that there were significant differences in radiologic changes between the groups. By 4 years after shockwave therapy, 20% of the entire patient population had undergone surgery on the involved shoulder. The effects of extracorporeal shockwave therapy not followed by any other therapy within the first 6 months were evaluated in 59% (n = 68) of the original 115 patients. Subjectively, 78% of patients in group A and 87% in group B thought the shockwave treatment had been successful. The Constant score increased from a mean of 45 before treatment to 88 in group A and 85 in group B after treatment. Radiologic changes were found in 93% of patients in each group. In conclusion, the failure rate after ESWT is high, but for 70% of the patients in this study, the treatment was successful and no long-term complications were seen.

Section snippets

Materials and methods

Outpatients with CT were screened for suitability for enrollment in the study. Patients who had persistent shoulder pain in combination with calcareous deposits in the supraspinatus or adjacent infraspinatus tendon were managed by the study protocol. Between 1995 and 1996, 115 patients (67 men and 48 women), with a mean age of 49 years (range, 28-77 years) and a mean 5-year history of pain (range, 1-36 years), were enrolled in the study and received ESWT. The inclusion criteria were painful CT

Results

The follow-up rate was 87% after 3 months and 72% after 6 months. Four years after ESWT (F3), 92% of the initial patient population (N = 115) was interviewed. Twenty-three patients (twenty percent) had had surgery on the affected shoulder since the treatment. Of the original patients, 68 (59%) were assessed with the protocol, with 13% refusing to undergo examination. Only 23% of group A (1 session of high-dose ESWT) and 37% of group B (2 sessions of high-dose ESWT) had received no further

Discussion

In the course of the 4-year follow-up after ESWT, the rate of surgical interventions performed was high. Given that 8% of patients were lost to follow-up, the percentage might be even higher than 20%. According to Geschwend et al,10 over 90% of patients with CT can be cured by conservative treatment. In a study of patients with CT by Harmon,11 17% underwent surgery. Only 1 patient out of 100 underwent surgery in a series published by Litchman et al.13 The main reason for this difference in

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  • Cited by (0)

    *

    Reprint requests: W. Daecke, MD, Department of Shoulder and Elbow Surgery, Orthopaedic University Hospital, University of Heidelberg, Schlierbacher Landstrasse 200 a, D-69118 Heidelberg, Germany.

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