Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study

Authors: Nikolaos Malliaropoulos, Dawn Thompson, Maria Meke, Debasish Pyne, Dimosthenis Alaseirlis, Henry Atkinson, Vasileios Korakakis, Heinz Lohrer

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Login to get access

Abstract

Background

A retrospective single centre cohort analysis was performed to evaluate an individualised radial extracorporeal shock wave therapy (rESWT) protocol for treatment of symptomatic calcific shoulder tendinopathy.

Methods

67 patients (79 Shoulders) were identified with 76 shoulders included for analysis. rESWT treatment protocol was adapted according to individual response to treatment. Variables included number of sessions, shockwave impulses, pressure and frequency. Success rate was estimated as the percentage of patients having ≥60% visual analogue score (VAS) pain decrease at follow-up. Recurrence at 1 year was recorded.

Results

Using this individualised symptom guided protocol, patients underwent a mean of 7 ± 1.5 rESWT sessions, with mean pressure of 1.7 ± 0.2 bar, mean frequency of 5 ± 0.3 Hz and 2175 ± 266 impulses. The mean pre-treatment VAS score of 6.7 ± 1.1 was significantly decreased to 3.2 ± 0.8 immediately post-treatment, 2.6 ± 0.9 at 1 month, 1.7 ± 1.0 at 3 months and 0.8 ± 1.0 at 1 year follow up (α = 0.05). One-year success rate was estimated at 92% and 1-year recurrence rate was 7%.

Conclusions

We conclude that in this retrospective study an individualised rESWT protocol resulted in a high success rate with low number of recurrences. Randomised controlled trials to support these findings are recommended.
Literature
1.
Riley GP, Harrall RL, Constant CR. Cawston TE, Hazleman BL. Prevalence and possible pathological significance of calcium phosphate salt accumulation in tendon matrix degeneration. Ann Rheumatic Dis 1996; 55: 109–115.
2.
Depalma AF, Kruper JS. Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop. 1961;20:61–72.PubMed
3.
Hughes PJ, Bolton-Maggs B. Calcifying tendinitis. Curr Orthop. 2002;16:389–94.CrossRef
4.
Harvie P, Pollard TCB, Carr AJ. Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elb Surg. 2007;16:169–73.CrossRef
5.
Wainner R, Hasz M. Management of acute calcific tendinitis of the shoulder. J Orthop Sports Phys Ther. 1998;27(Suppl 3):231–6.CrossRefPubMed
6.
Le Goff B, Berthelot JM, Guillot P, Glemarec J, Maugars Y. Assessment of calcific tendonitis of rotator cuff by ultrasonography: comparison between symptomatic and asymptomatic shoulders. Joint Bone Spine. 2010;77:258–63.CrossRefPubMed
7.
Uhthoff HK. Calcifying tendinitis, an active cell-mediated calcification. Virchows Arch. 1974;366:51–8.CrossRef
8.
9.
Kachewar SG, Kulkarni DS. Calcific tendinitis of the rotator cuff: a review. J Clin Diagn Res. 2013;7(Suppl 7):1482–5.PubMedPubMedCentral
10.
Speed CA, Hazleman BL. Calcifying tendinitis of the shoulder. N Engl J Med. 1999;340(Suppl 20):1582–4.CrossRefPubMed
11.
Re LP Jr, Karzel RP. Management of rotator cuff calcifications. Orthop Clin North Am 1993; 24: 125–132.
12.
De Seze S, Welfling J. Tendinites calcifiantes. Rhumatologie. 1970;22:5–14.
13.
Pfister J, Gerber H. Chronic calcifying tendinitis of the shoulder-therapy by percutaneous needle aspiration and lavage: a prospective open study of 62 shoulders. Clin Rheumatol. 1997;16(Suppl 3):269–74.CrossRefPubMed
14.
Kaada B. Treatment of peritendinitiscalcarea of the shoulder by transcutaneous nerve stimulation. AcupunctElectrother Res. 1984;9:115–25.
15.
Cacchio A, Paoloni M, Barile A, Don R, de Paulis F, Calvisi V, et al. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single bind randomized clinical study. Phys Ther. 2006;86:672–82.PubMed
16.
Spacca G, Necozione S, Cacchio A. Radial shock wave therapy for lateral epicondylitis: a prospective randomized controlled single-blind study. Eura Medicophys. 2005;41(Suppl 1):17–25.PubMed
17.
Gerdesmeyer L, Vester FC, Maier M, Weil L, Russlies M, Stienstra J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicentre study. Am J Sports Med. 2008;36(Suppl 11):2100–9.CrossRefPubMed
18.
Malliaropoulos N, Jury R, Pyne D, Padhiar N, Turner J, Korakakis V, Meke M, Lohrer H. Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit). Open Access J Sports Medicine. 2016;7:143–51.CrossRef
19.
Malliaropoulos N, Crate G, Meke M, Korakakis V, Nauck T, Lohrer H, Padhiar N. Success and recurrence rate after radial extracorporeal shock wave therapy for plantar fasciopathy: a retrospective study. Biomed Res Int. 2016:9415827.
20.
Malliaropoulos N, Crate G, Meke M, Nauck T, Lohrer H, Padhiar N. Sessions Required for rESWT Treatment. Any evidence Base? Oral presented at Shock Wave Berlin. Second International Shock Wave Conference. 3–4 October 2014.
21.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VASPain), Numeric Rating Scale for Pain (NRS Pain), McGill PainQuestionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res. 2011;63:S240–52.CrossRef
22.
Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wortler K, et al. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003;290:2573–80.CrossRefPubMed
23.
Avancini-Dobrovic V, Frlan-Vrgoc L, Stamnekovic D, Pavlovic L, Vrbanic TS. Radial extracorporeal shock wave therapy for the treatment of shoulder calcific tendinitis. Coll Antropol. 2011;35(Suppl 2):221–5.PubMed
24.
Mangone G, Veliaj A, Postiglione M, Viliani T, Pasquetti P. Radial extracorporeal shock-wave therapy in rotator cuff calcific tendinosis. Clin cases Miner Bone Metab. 2010;7(Suppl 2):91–6.PubMedPubMedCentral
25.
Huisstede BMA, Gebremariam L, van der Sande R, Hay EM, Koes BW. Evidence for effectiveness of extracorporeal shock-wave therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis – a systematic review. Man Ther. 2011;16:419–33.CrossRefPubMed
26.
Louwerens JKG, Sierevelt IN, van Noort A, van den Bekerom MPJ. Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis. J Shoulder Elb Surg. 2014;23(Suppl 8):1240–9.CrossRef
27.
Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. J Am Acad Orthop Surg. 1997;5(Suppl 4):183–91.CrossRefPubMed
28.
Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop. 1976;118:164–8.
29.
Bosworth BM. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12,122 shoulders. JAMA. 1941;116:2477–82.CrossRef
30.
Gartner J, Simons B. Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Relat Res. 1990;254:111–20.
31.
Constant CR, Murley AHA. Clinical method of functional assessment of the shoulder. Clin Orthop. 1987;214:160–4.
Metadata
Title
Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study
Authors
Nikolaos Malliaropoulos
Dawn Thompson
Maria Meke
Debasish Pyne
Dimosthenis Alaseirlis
Henry Atkinson
Vasileios Korakakis
Heinz Lohrer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1873-x

Other articles of this Issue 1/2017

BMC Musculoskeletal Disorders 1/2017 Go to the issue

Research article

How to avoid unintended valgus alignment in distal femoral derotational osteotomy for treatment of femoral torsional malalignment - a concept study

Research article

Strontium ranelate causes osteophytes overgrowth in a model of early phase osteoarthritis

Research article

Cervical spine reposition errors after cervical flexion and extension

Research article

Plasminogen activator inhibitor-1 deficiency enhances subchondral osteopenia after induction of osteoarthritis in mice

Research article

Sex differences in gout characteristics: tailoring care for women and men

Research article

Long-term outcome following upper extremity replantation after major traumatic amputation