Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study

doi:10.1177/03635465231217733

科研成果详情

题名	Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study
作者	Chen, Fanglin 1,3; Deng, Zhenhan1,4; Liu, Yan 1,5; Chen, Renqiang 1,3; Chen, Kenian 1,3; Xu, Jian 1,2
发表日期	2024-02
发表期刊	AMERICAN JOURNAL OF SPORTS MEDICINE 影响因子和分区
语种	英语
原始文献类型	Article
关键词	calcific tendinitis arthroscopic calcium deposit removal nonoperative treatment operative management rotator cuff rotator cuff tear
其他关键词	SHOCK-WAVE THERAPY ; ROTATOR CUFF ; PROGNOSTIC-FACTORS ; TENDINOPATHY ; PATTERN ; PAIN
摘要	Background: Treatment options for calcific tendinitis (CT) of the shoulder remain controversial. A consensus for an operative indication for this condition is lacking. Purpose: To compare nonoperative versus operative treatment for shoulder CT and analyze factors affecting the prognosis after treatment. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 180 patients diagnosed with symptomatic CT between January 2017 and September 2021 were evaluated in this retrospective cohort study. There were 103 patients treated nonoperatively at our institution, which included the use of nonsteroidal anti-inflammatory drugs, acupuncture, steroid injections, extracorporeal shock wave therapy, and ultrasound-guided needle aspiration/percutaneous irrigation. However, 77 patients were treated with arthroscopic surgery after 6 months of failed nonoperative treatment. The visual analog scale (VAS) for pain, the Constant-Murley score, and imaging were used to assess and evaluate outcomes. Descriptive data, functional outcomes, and imaging findings were compared between the operative and nonoperative groups before and after propensity score matching. Additionally, prognostic factors including calcium deposit size, tendon infiltration by calcium deposits, involvement of single or multiple tendons, and occurrence of rotator cuff tears were analyzed by comparing the groups to determine their effect on treatment options and recovery. Results: Magnetic resonance imaging showed that the supraspinatus tendon (66.7%) was most commonly involved, followed by the infraspinatus (42.8%) and subscapularis (21.1%) tendons. Tendon infiltration by calcium deposits was observed in 84.4% of the patients, and rotator cuff tears occurred in 30.0% of the patients. After propensity score matching, there was no significant difference in changes in the Constant-Murley score (48.1 +/- 25.4 vs 49.0 +/- 22.8, respectively; P = .950) and VAS score (4.9 +/- 2.3 vs 4.5 +/- 1.9, respectively; P = .860) between the operative and nonoperative groups at the final follow-up. However, for patients with shoulder CT and without rotator cuff tears, there was a significant difference in changes in the Constant-Murley score (52.93 +/- 25.18 vs 42.13 +/- 22.35, respectively; P = .012) and VAS score (5.21 +/- 2.06 vs 3.81 +/- 1.98, respectively; P < .001) between the operative and nonoperative groups, but the recovery time in the operative group was longer than that in the nonoperative group (86.92 +/- 138.56 vs 30.42 +/- 54.97 days, respectively; P = .016). The results also showed that calcium deposit size, involvement of multiple tendons, and tendon infiltration by calcium deposits did not affect the recovery time after treatment. The survival analysis showed that rotator cuff tears affected the complete recovery of shoulder function. Conclusion: This study demonstrated no significant difference between nonoperative and operative treatment for patients with shoulder CT, on the whole. However, for patients with shoulder CT and without rotator cuff tears, the effect of operative treatment was better than that of nonoperative treatment; yet, operative treatment was shown to prolong the recovery time. Calcium deposit size, tendon infiltration by calcium deposits, and involvement of multiple tendons did not correlate with recovery time or the recovery of function. A rotator cuff tear was the only factor affecting the complete recovery of shoulder function.
资助项目	National Natural Science Foundation of China [82102632, 82160412]; Guangxi Natural Science Foundation [2020GXNSFBA297089]; Youth and Talent Research Project of Guangxi Science and Technology [AD21220065]; Liuzhou Science and Technology Project [2021CBB0106]
出版者	SAGE PUBLICATIONS INC
ISSN	0363-5465
EISSN	1552-3365
卷号	52 期号:2 页码:461-473
DOI	10.1177/03635465231217733
页数	13
WOS类目	Orthopedics ; Sport Sciences
WOS研究方向	Orthopedics ; Sport Sciences
WOS记录号	WOS:001156895900022
收录类别	SCIE ; PUBMED
URL	查看原文
PubMed ID	38426316
通讯作者地址	[Xu, Jian]Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Orthopaed, 79 Qingchun Rd, Hangzhou 310000, Peoples R China.
TOP期刊	TOP期刊
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/206968
专题	附属第一医院_骨科
通讯作者	Xu, Jian
作者单位	1.Guangxi Med Univ, Liuzhou Workers Hosp, Affiliated Hosp 4, Liuzhou, Peoples R China; 2.Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Orthopaed, 79 Qingchun Rd, Hangzhou 310000, Peoples R China; 3.Guangxi Med Univ, Liuzhou Workers Hosp, Affiliated Hosp 4, Dept Orthopaed, Liuzhou, Peoples R China; 4.Wenzhou Med Univ, Affiliated Hosp 1, Dept Orthopaed Surg, Wenzhou, Zhejiang, Peoples R China; 5.Shenzhen Univ, Shenzhen Peoples Hosp 2, Affiliated Hosp 1, Dept Sports Med, Shenzhen, Peoples R China
推荐引用方式 GB/T 7714	Chen, Fanglin,Deng, Zhenhan,Liu, Yan,et al. Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study[J]. AMERICAN JOURNAL OF SPORTS MEDICINE,2024,52(2):461-473.
APA	Chen, Fanglin, Deng, Zhenhan, Liu, Yan, Chen, Renqiang, Chen, Kenian, & Xu, Jian. (2024). Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study. AMERICAN JOURNAL OF SPORTS MEDICINE, 52(2), 461-473.
MLA	Chen, Fanglin,et al."Arthroscopic Surgery Versus Nonoperative Treatment for Calcific Tendinitis of the Shoulder: A Retrospective Cohort Study".AMERICAN JOURNAL OF SPORTS MEDICINE 52.2(2024):461-473.