Albert J-D, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, Chalès G
Department of Rheumatology, Clinique Mutualiste La Sagesse, 4 place Saint Guenolè, 35043 Rennes Cedex, France.
J Bone Joint Surg Br. 2007 Mar;89(3):335-41. doi: 10.1302/0301-620X.89B3.18249.
In a prospective randomised trial of calcifying tendinitis of the rotator cuff, we compared the efficacy of dual treatment sessions delivering 2500 extracorporeal shock waves at either high- or low-energy, via an electromagnetic generator under fluoroscopic guidance. Patients were eligible for the study if they had more than a three-month history of calcifying tendinitis of the rotator cuff, with calcification measuring 10 mm or more in maximum dimension. The primary outcome measure was the change in the Constant and Murley Score. A total of 80 patients were enrolled (40 in each group), and were re-evaluated at a mean of 110 (41 to 255) days after treatment when the increase in Constant and Murley score was significantly greater (t-test, p = 0.026) in the high-energy treatment group than in the low-energy group. The improvement from the baseline level was significant in the high-energy group, with a mean gain of 12.5 (-20.7 to 47.5) points (p < 0.0001). The improvement was not significant in the low-energy group. Total or subtotal resorption of the calcification occurred in six patients (15%) in the high-energy group and in two patients (5%) in the low-energy group. High-energy shock-wave therapy significantly improves symptoms in refractory calcifying tendinitis of the shoulder after three months of follow-up, but the calcific deposit remains unchanged in size in the majority of patients.
在一项关于肩袖钙化性肌腱炎的前瞻性随机试验中，我们比较了在透视引导下通过电磁发生器以高能量或低能量方式进行2500次体外冲击波双疗程治疗的疗效。如果患者有超过三个月的肩袖钙化性肌腱炎病史，且钙化最大直径测量为10毫米或更大，则符合该研究条件。主要结局指标是Constant和Murley评分的变化。总共招募了80名患者（每组40名），并在治疗后平均110天（41至255天）进行重新评估，此时高能量治疗组的Constant和Murley评分增加显著大于低能量组（t检验，p = 0.026）。高能量组从基线水平的改善显著，平均增加12.5分（-20.7至47.5分）（p < 0.0001）。低能量组的改善不显著。高能量组有6名患者（15%）钙化完全或部分吸收，低能量组有2名患者（5%）钙化吸收。高能量冲击波治疗在随访三个月后可显著改善难治性肩部钙化性肌腱炎的症状，但大多数患者的钙化沉积物大小保持不变。
