Rotator Cuff Calcific Tendonitis: Short-term and 10-year Outcomes After Two-Needle Ultrasound guided Percutaneous Treatment: Nonrandomized Controlled Trial

A quick, low-cost treatment with ultrasound guided percutaneous needles provides up to a year of effective pain relief for patients with rotator cuff calcific tendonitis, researchers have found.

Giovanni Serafini, M.D., of the Unit of Radiology at Ospedale Santa Corona in Pietra Ligure, Italy, and colleagues investigated an ultrasound guided treatment under local anesthetic using two 16-gauge needles inserted into the calcium deposit—one needle injecting saline solution, the other retrieving dissolved calcium. Each procedure lasted about 20 minutes.

Graphs illustrate evolution of (a) Constant and (b) VAS scores in patients with rotator cuff calcific tendonitis; 235 shoulders were treated and 68 shoulders were not treated. Data are mean scores ± standard deviations. Significant differences (*) between treated and nontreated patients are illustrated.

Exact location and appearance of calcified tendons were determined in advance with ultrasound imaging. Patients were assessed using the Constant Score method consisting of two subjective measurements of pain and its relation to activities of daily living and two objective measurements—strength and range of motion as assessed by a physician. Researchers treated one shoulder in 203 patients and both shoulders in two separate sessions in 16 patients, for 235 shoulders in all. Reassessment was made at one and three months and at one, five and 10 years after treatment.

"Treated patients had a better outcome compared to the control group up to one year, although both groups showed a similar long-term outcome," Dr. Serafini and colleagues wrote. The procedure provided "a prompt and long-standing recovery as compared with a somewhat longer duration of pain and functional impairment in untreated controls.

"As calcific tendonitis is a self-limited condition, its treatment should be effective, complication-free and minimally invasive," the researchers conclude. "A two-needle technique for percutaneous ultrasound-guided treatment of rotator cuff tendinitis was an effective, quick and low-cost therapy."

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