Summary

Ultrasound-guided puncture-aspiration and arthroscopic treatment offer good results for the treatment of rotator cuff calcific tendinopathy. Both treatments bring about significant clinical and functional improvement in patients. In this study, no statistically significant differences were found in terms of improvements on the DASH scale or Constant scale at 6 and 12 months in patients treated by

Abstract

Calcific tendinopathy of the rotator cuff is one of the main causes of the non-traumatic painful shoulder between 40-60 years of age. It can cause acute and chronic inflammatory symptoms with disabling pain.
Objectives
The objective of the study was to compare the therapeutic effectiveness of ultrasound-guided puncture-aspiration versus arthroscopic treatment for rotator cuff calcific tendinopathy in patients in whom conservative treatment has failed.
Study Design & Methods
All patients treated by means of ultrasound-guided puncture-aspiration and/or arthroscopic treatment for rotator cuff calcific tendinopathy in our center from May 2017 to January 2019 were included. Demographic data, the morphology and location of the lesion, the therapeutic procedure as well as its clinical evolution were retrospectively evaluated using the Constant and DASH scales. The evaluations were carried prior to the procedures and at six months and one year after the intervention. A statistical analysis of the data was carried out using the SPSS Statistics software package.

Results

The mean age of the 32 patients who were included was 46 years and 21 (65.6%) of them were women. Ultrasound-guided puncture-aspiration was carried out on 17 patients (53.1%) and 15 patients (46.9%) were treated with resection and arthroscopic repair. In 3 cases (9.3%), both therapeutic techniques were performed due to there being no clinical improvement after performing ultrasound-guided puncture-aspiration alone. The lesion affected the dominant shoulder in 91% of the patients. The lesion was located in the supraspinatus tendon in 94% of all the cases. The score on the DASH scale and Constant scale prior to treatment in the ultrasound-guided aspiration group was 51.2 and 39.8, respectively. After the therapeutic procedure, they stood at 17.3 and 82 at 6 months and 14.3 and 87 at 12 months, respectively. The DASH scale and Constant scale scores in the arthroscopic group were 49.2 and 42.5 before treatment. After surgery, they were 26.7 and 70.5 at 6 months and 16.6 and 84.5 at 12 months. No statistically significant differences were seen in the statistical analysis relative to the Constant and DASH scales in the evaluations prior to surgery. Neither were any statistically significant differences seen at 6 and 12 months for either of the two therapeutic procedures.

Conclusions

Ultrasound-guided puncture-aspiration and arthroscopic treatment offer good results for the treatment of rotator cuff calcific tendinopathy. Both treatments bring about significant clinical and functional improvement in patients. In this study, no statistically significant differences were found in terms of improvements on the DASH scale or Constant scale at 6 and 12 months in patients treated by ultrasound-guided aspiration when compared to those treated with arthroscopic surgery.