Extrakorporale Stoßwellentherapie bei der Tendionosis calcarea der Rotatorenmanschette: Vergleich verschiedener Behandlungsprotokolle

Seil, Romain; Rupp, S.; Ds, Hammer; Ensslin, Stefan; Gebhardt, Th.; Kohn, Dieter

doi:10.1055/s-2008-1039717

Cited by 38 publications

(5 citation statements)

References 6 publications

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“… 6 8.5 1200 + − + + − − + − + − Plantar fasciopathy Hammer et al 110 + Piezoson 300 (Wolf) PE 0.20 (?) 3 7 3000 + − + − − − + − + + 4 Calcifying tendonitis of the shoulder Seil et al 111 + Piezolith 2501 (Wolf) PE 0.10 and 0.30 (?) 3 7 5000 + − + − − − + − + − 1 5000 Loew et al 112 + MFL 5000 (Philips) and Compact (Dornier) EH 0.10 …”

Section: Resultsunclassified

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

et al. 2015

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BackgroundExtracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.Sources of dataThis systematic review used data derived from the Physiotherapy Evidence Database (PEDro; , 23 October 2015, date last accessed).Areas of agreementESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate.Areas of controversyThe distinction between radial ESWT as ‘low-energy ESWT’ and focused ESWT as ‘high-energy ESWT’ is not correct and should be abandoned.Growing pointsThere is no scientific evidence in favour of either radial ESWT or focused ESWT with respect to treatment outcome.Areas timely for developing researchFuture randomized controlled trials should primarily address systematic tests of the aforementioned optimum treatment protocol and direct comparisons between radial and focused ESWT.

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Section: Resultsunclassified

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

et al. 2015

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“…Many authors have reported good results with low- or high-energy shock wave therapy in patients with calcifying tendinitis of the shoulder [2, 8, 25, 33, 39]. Rompe et al [30] compared ESWT with conventional surgery in the treatment of calcifying tendinitis of the shoulder.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy surgery versus shock wave therapy for chronic calcifying tendinitis of the shoulder

Rebuzzi¹,

Coletti²,

Schiavetti³

et al. 2008

J Orthopaed Traumatol

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BackgroundThere are several treatment modalities for calcifying tendinitis of the shoulder. If the pain becomes chronic after several months of conservative treatment, open or arthroscopic removal is usually recommended. Recently, extracorporeal shock wave therapy has shown encouraging results in treating calcific deposits.Materials and methodsWe report a retrospective study to compare the outcome after arthroscopic extirpation (group I, 22 cases) with the effect of low extracorporeal shock wave therapy (group II, 24 cases) in patients with a chronic homogeneous calcific deposit in the supraspinatus tendon. Patients included in the study had undergone unsuccessful conservative therapy in the previous six months with no evidence of subacromial impingement of the rotator cuff independent of the calcium deposit or rupture of the rotator cuff detected by sonography or magnetic resonance imaging. AP and LL radiographies were performed for all of the patients at least one week before the treatment and 24 months after the treatment. To keep the possibility of spontaneous resorption low, the deposit had to be sharply outlined and densely structured on the radiograph (types I and II in the Gärtner classification). In group II, the patients underwent an average of three treatment sessions of extracorporeal shock waves therapy with 1,500 impulses/session of 0.10–0.13 mJ/mm2.ResultsPreoperative symptoms (P = 0.09), sex (P = 0.17), operated (P = 0.11) and dominant (P = 0.33) limbs, and age (P = 0.99) of the two groups did not show a significative difference between groups. According to the University of California Los Angeles (UCLA) rating system, the mean score in group I improved from 9.36 (±5.2) to 30.3 (±7.62) points after 24 months, with 81.81% reporting good or excellent results (P < 0.001). In group II the mean score after 24 months rose from 12.38 (±6.5) to 28.13 (±9.34) points, with 70.83% reporting good or excellent results (P < 0.001). Radiologically, after two years of follow up, there was no calcific deposit in 86.35% (P < 0.001) of the patients of group I and in 58.33 % (P < 0.001) of the patients of group II. According to the UCLA scores, there was no significant difference between the groups at two years of follow-up (P = 0.38).Conclusions We conclude that shock wave therapy is equivalent to arthroscopy, and so shock wave therapy should be preferred because of its noninvasiveness.

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“…A possible influence of failed preoperative ESWT on postoperative results after arthroscopic treatment of calcifying tendonitis was to our knowledge not investigated in the literature. But this becomes relevant as the success rates of ESWT in the treatment of calcifying tendonitis vary from 28 to 70% in the literature [17, 18, 26]. This implies that 30–70% require surgical treatment after ESWT.…”

Section: Discussionmentioning

confidence: 99%

“…But the influence of a failed preoperative ESWT on the clinical outcome after arthroscopic removal of the calcific deposit was to our knowledge not investigated in recent studies. However, a possible influence might be of great importance concerning the treatment regimen as the success rates of ESWT are reported from 28 to 70% [17, 18, 26] in the literature, which means that 30–70% of the patients might undergo surgery after failed ESWT.…”

Section: Introductionmentioning

confidence: 99%

Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder

Lorbach

Kusma

Pape

et al. 2008

Knee Surg Sports Traumatol Arthr

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The purpose of the present study is the evaluation of a possible influence of the preoperative deposit stage, the postoperative deposit elimination and failed preoperative extracorporeal shockwave therapy on the surgical outcome of arthroscopic treatment of tendinosis calcarea. From 1997 to 2004, 65 patients underwent arthroscopic resection of calcific deposits of the shoulder after failed conservative treatment. Patients with rotator cuff tears, major cartilage damage, or previous surgery were excluded. Out of 50 patients 45 (17 men, 28 women) that could be contacted with a mean age of 49 +/- 8 years could be followed-up with a mean of 36 months (14-89) after surgery. A total of 24 patients (53.3%) underwent preoperative extracorporeal shock-wave therapy (ESWT). For the clinical evaluation the Constant and Murley Score, the Simple Shoulder Test, the Western Ontario Rotator Cuff Index (WORC) and visual analog scales for pain, function and satisfaction were used. For the radiological evaluation, the classifications according to Gaertner and Bosworth were used. Statistical analysis was done with the Wilcoxon test, the Mann-Whitney test and ANOVA. The Constant and Murley Score improved significantly from preoperative 63.5 +/- 11.4 to postoperative 93.9 +/- 9.9 points (P < .0001) at follow-up, the Simple Shoulder Test from 1.7 +/- 2 to 9.9 +/- 2.8 points (P < .0001), the WORC score from 1,591.2 +/- 337.4 to 345.4 +/- 392 points (P < .0001). The visual analog scales for pain, function and patient satisfaction also significantly improved (P < .0001). Preoperative radiological evaluation according to the Gaertner classification revealed 37 type I deposits, 6 type II and 2 type III deposits; postoperative no calcific deposits were seen in 37 patients, 6 type I and 2 type III deposits. According to the Bosworth classification 13 type I, 19 type II and 13 type III deposits were seen preoperatively. Postoperative X-rays showed 6 type I and 1 type II and III deposits. There was no significant correlation of the clinical results with the pre- or postoperative findings. The 24 patients who underwent ESWT before surgery did not show significantly better results than patients without ESWT. In conclusion, arthroscopic removal of calcific deposits of the shoulder shows good clinical results for pain reduction, shoulder function and patient satisfaction. The type of calcific deposit and the preoperative treatment of the shoulder with ESWT did not have any significant impact on the postoperative results.

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Extrakorporale Stoßwellentherapie bei der Tendionosis calcarea der Rotatorenmanschette: Vergleich verschiedener Behandlungsprotokolle

Abstract: Extracorporeal shock wave therapy may be an alternative treatment of calcifying tendinitis of the shoulder. Both treatment protocols gave equivalent results.

Cited by 38 publications

References 6 publications

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Arthroscopy surgery versus shock wave therapy for chronic calcifying tendinitis of the shoulder

Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder

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