Extracorporeal Shock Wave Therapy in the Treatment of Calcific Tendinitis of the Rotator Cuff

Abstract

Three-dimensional, computer-assisted navigation reveals significantly better results and is therefore recommended when extracorporeal shock wave therapy is used in the treatment of calcific tendinitis of the rotator cuff.

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

“…Several large randomized, controlled trials report good results using ESWT in the treatment of calcific tendonitis of the rotator cuff with a reported improvement in pain scores and a decrease in the size of calcific deposits seen on radiographs compared with placebo [4,31,39,59,98,110,123,130,131,136,140]. One advantage to treating calcific tendonitis with this method is the ability to visualize the area of pathology and target this area with the shock waves [67,74,150]. Improved efficacy has been demonstrated when using computer-guided navigation when applying shock waves to calcific tendonitis [150].…”

“…One advantage to treating calcific tendonitis with this method is the ability to visualize the area of pathology and target this area with the shock waves [67,74,150]. Improved efficacy has been demonstrated when using computer-guided navigation when applying shock waves to calcific tendonitis [150]. The effectiveness of ESWT for treating noncalcific tendonitis has been less promising.…”

A comparison of two different treatments with navigated extracorporeal shock-wave therapy for calcifying tendinitis – a randomized controlled trial

“…Patients in a study by Sabeti et al [5] attained significant improvement in the CMS and VAS after three sessions of low-energy SWT (0.08 mJ/mm 2 ) without local anesthesia, and after three months of follow up there was greater improvement in both scores after navigated SWT than with biofeedback localization. Wang et al [10] included 44 patients in a prospective placebo-controlled trial.…”

“…The reason for scheduling the follow-up at three months is that this investigation was based on Sabeti's findings [5]. In addition, Seil et al [14] reported that the SWT-associated effect is mostly evident within the first six weeks after treatment and that an effect after three months is rather unusual.…”

“…Both groups of patients received two sessions of 4000 impulses of 0.78 mJ/mm 2 under local anesthesia. In a prospective, randomized trial of a comparison of navigated versus biofeedback localization, Sabeti et al [5] reported significant clinical and radiological improvement after navigated low-energy SWT (0.08 mJ/mm 2 ; 1000 impulses) in 50 patients and therefore highly recommended the use of a navigation device. Overall, these studies demonstrate notably significant clinical improvement after objective localization using X-rays compared with any other form of localization, and the trend of the results was that lowenergy SWT gave poorer results than middle-or highenergy SWT.…”