Serafini Giovanni, Sconfienza Luca M, Lacelli Francesca, Silvestri Enzo, Aliprandi Alberto, Sardanelli Francesco
Unit of Radiology, Azienda Sanitaria Locale 2 Savonese, Ospedale Santa Corona, Via XXV Aprile 38, 17027 Pietra Ligure, Italy.
Radiology. 2009 Jul;252(1):157-64. doi: 10.1148/radiol.2521081816.
To compare short- and long-term outcomes of patients with rotator cuff calcific tendonitis who did and did not undergo ultrasonographically (US)-guided percutaneous treatment.
Institutional review board approval and informed patient consent were obtained. Of patients referred for US-guided treatment of rotator cuff calcific tendonitis, 219 (86 men, 133 women; mean age, 40.3 years +/- 10.9 [standard deviation]) were treated; 68 (31 men, 37 women; mean age, 40.2 years +/- 11.3) patients refused treatment and served as control subjects. After local anesthesia was induced, two 16-gauge needles were inserted into the calcific deposit. Saline solution was injected through one needle, and the dissolved calcium was extracted through the other needle. Shoulder joint function was assessed by using Constant scores, and pain was assessed by using visual analogue scale (VAS) scores. Mann-Whitney U and chi(2) tests were performed.
At baseline, no significant difference in age or sex distribution, Constant score, or VAS score was detected between treated and nontreated (control) patients. Compared with control subjects, treated patients reported a significant decrease in symptoms at 1 month (mean Constant score, 73.2 +/- 6.2 vs 57.5 +/- 3.9; mean VAS score, 4.8 +/- 0.6 vs 9.1 +/- 0.5), 3 months (mean Constant score, 90.2 +/- 2.6 vs 62.6 +/- 7.2; mean VAS score, 3.3 +/- 0.4 vs 7.3 +/- 1.8), and 1 year (mean Constant score, 91.7 +/- 3.1 vs 78.4 +/- 9.5; mean VAS score, 2.7 +/- 0.5 vs 4.5 +/- 0.9) (P < .001). Symptom scores were not significantly different between the groups at 5 years (mean Constant score, 90.9 +/- 3.6 vs 90.5 +/- 4.8; mean VAS score, 2.6 +/- 0.5 vs 2.8 +/- 0.7) (P >or= .795) and 10 years (mean Constant score, 91.8 +/- 5.0 vs 91.3 +/- 9.6; mean VAS score, 2.5 +/- 0.6 vs 2.7 +/- 0.6) (P >or= .413).
US-guided percutaneous treatment facilitated prompt shoulder function recovery and pain relief. Treated patients had better outcomes than did nontreated patients at 1 year. However, 5 and 10 years after the procedure, the nontreated group reported outcomes similar to those of the treated group.
比较接受和未接受超声(US)引导下经皮治疗的肩袖钙化性肌腱炎患者的短期和长期预后。
获得机构审查委员会批准并取得患者知情同意。在因肩袖钙化性肌腱炎而转诊接受US引导治疗的患者中,219例(86例男性,133例女性;平均年龄40.3岁±10.9[标准差])接受了治疗;68例(31例男性,37例女性;平均年龄40.2岁±11.3)患者拒绝治疗并作为对照。在诱导局部麻醉后,将两根16号针插入钙化沉积物。通过一根针注入生理盐水,通过另一根针抽出溶解的钙。使用Constant评分评估肩关节功能,使用视觉模拟量表(VAS)评分评估疼痛。进行Mann-Whitney U检验和卡方检验。
在基线时,治疗组和未治疗(对照)组患者在年龄或性别分布、Constant评分或VAS评分方面未检测到显著差异。与对照组相比,治疗组患者在1个月(平均Constant评分,73.2±6.2对57.5±3.9;平均VAS评分,4.8±0.6对9.1±0.5)、3个月(平均Constant评分,90.2±2.6对62.6±7.2;平均VAS评分,3.3±0.4对7.3±1.8)和1年(平均Constant评分,91.7±3.1对78.4±9.5;平均VAS评分,2.7±0.5对4.5±0.9)时症状显著减轻(P<.001)。两组在5年(平均Constant评分,90.9±3.6对90.5±4.8;平均VAS评分,2.6±0.5对2.8±0.7)(P≥.795)和10年(平均Constant评分,91.8±5.0对91.3±9.6;平均VAS评分,2.5±0.6对2.7±0.6)(P≥.413)时症状评分无显著差异。
US引导下经皮治疗有助于促进肩关节功能迅速恢复和疼痛缓解。治疗组患者在1年时的预后优于未治疗组。然而,在治疗后5年和10年,未治疗组报告的预后与治疗组相似。