Efficacy of triamcinolone acetate and methylprednisolone acetonide for intrabursal injection after ultrasound-guided percutaneous treatment in painful shoulder calcific tendonitis: a randomized controlled trial

Abstract

Background Ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) with intrabursal steroid injection is an elective treatment for painful rotator cuff calcific tendinopathy. Purpose To compare the efficacy of post-US-PICT intrabursal 40 mg injection of triamcinolone acetonide (TA) versus methylprednisolone acetate (MA). Material and Methods Forty patients (22 women; mean age 48.7 ± 7.2 years) with painful shoulder calcific tendinopathy, treated with TA or MA injected intrabursally after US-PICT, were included in this randomized controlled trial. At baseline and after 1, 7, 15, 30, 45, and 180 days, patients underwent US and clinical examination, using Constant (CS) and VAS (VS) scores. Complications and analgesic use were also recorded. Results Compared to baseline, at the 45-day follow-up, TA and MA group showed a similar improvement (Δ) in CS (42 ± 10 versus 36 ± 9 points) and VS (-4.4 ± 1.3 versus -3.6 ± 1.3 points). At the 180-day follow-up, the improvement was higher in TA versus MA (ΔCS: 53 ± 7 versus 44 ± 7 points; ΔVS: -4.9 ± 1.1 versus -3.9 ± 1 points). Multivariate analysis showed a mean CS higher ( P = 0.02) in TA versus MA group, while VS was similar. TA had a 5 × higher ( P = 0.007) chance of reaching complete remission (CS = 100 points) than MA group. A progressive decrease in analgesic use, concomitant to a significant and similar reduction of bursitis and calcifications, was observed in both groups. No major complications occurred. Conclusion Two-needle US-PICT with intrabursal steroid injection is safe and effective. The chance of reaching better scores and, even more important for a clinical perspective, of functional recovery, is higher in patients treated with TA than MA.

Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study

“…The visual analog scale (VAS) for pain was used to assess pain, and the Constant-Murley score was used to assess shoulder function. The VAS and Constant-Murley scores before treatment and at the final follow-up after treatment, along with the time required for complete recovery, were collected (complete recovery after treatment was defined as a Constant-Murley score of 100 1 ).…”

“…A total of 259 patients diagnosed with symptomatic CT between January 2017 and September 2021 were evaluated for inclusion in this retrospective study. The inclusion criteria were as follows: (1) imaging showing calcium deposits and (2) patients treated nonoperatively or operatively at our institution. The exclusion criteria were as follows: (1) missing treatment records; (2) shoulder pain caused by acute trauma instead of CT; (3) a history of shoulder surgery; (4) cervical spondylosis, shoulder dislocations, superior labrum anterior to posterior injuries, previous frozen shoulder, or other conditions causing shoulder pain; (5) renal failure with renal insufficiency and longterm hemodialysis; or (6) inability to complete the last follow-up because of death.…”

Heterotopic Ossification in Hip Arthroscopy: an Updated Review

“…Ultrasound (US)-guided lavage has been used in the past for other calcified soft tissue entities such as calcific tendinitis of the rotator cuff with reasonable results [27,28]. The literature is scarce on adopting this technique for HO management; however, a single-case report discusses this technique for HO in hip arthroscopy and shows good result [8•].…”