[Radial shock wave therapy in calcifying tendinitis of the rotator cuff--a prospective study].
OBJECTIVE
The aim of the study is to evaluate the influence of radial shock wave therapy (RSWT) on the course of calcifying tendinitis of the rotator cuff.


METHODS
35 patients with a mean age of 47.5 years suffering from calcifying tendinitis stage Gaertner 2 with a mean size of 16.6 mm in typical location (true-ap view) for a mean of 28 months were treated by low-energy RSWT three times. The acromio-humeral distance averaged 10.4 mm measured at the true-ap view. All patients were clinically and radiologically followed-up at 4 weeks, 3, 6 and 12 months after the last treatment.


RESULTS
The Constant score improved significantly (p < 0.0001) during the first 4 weeks after RSWT from a mean of 68.5 to a mean of 80.5 points and remained approximatively constant at 3, 6 and 12 months follow-up. After 4 weeks 25.7% of the patients had no pain, 54.3% reported about pain relief. In the course of the follow-up a significant improvement of pain was observed: up to 80.8% painless and 19.2% pain relief 12 months after RSWT. Radiologically 4 weeks after RSWT the X-ray examination showed in 17.6% no calcific deposit, in 20.5% a disintegration and in 61.5% no changes of the calcific deposit. At further follow-up we found a complete resorption of the calcific deposit in 75% up to 12 months after RSWT and 25% had no change in calcific deposit. Overall three patients (8.5%) had to undergo surgical treatment 3-7 months after RSWT.


CONCLUSIONS
The low-energy RSWT leads within the first 4 weeks to a significant pain relief and an improvement of shoulder function. In consideration of the long history, the size and the spontaneous resorption rate of the calcific deposit, an inductive effect of RSWT on the resorption of the calcific deposit can be assumed.
Magosch
P
P
Schulter- und Ellenbogenchirurgie, ATOS-Praxisklinik, Heidelberg. Wissenschaft@atos.de
Lichtenberg
S
S
Habermeyer
P
P
D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D017006:Rotator Cuff; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000628:therapy*; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome