Department for Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130, Vienna, Austria.
Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2085-9. doi: 10.1007/s00167-011-1479-z. Epub 2011 Mar 23.
Strategies for extracorporeal shockwave therapy in calcifying tendinitis of the rotator cuff vary concerning quantity of sessions and doses. The purpose of this prospective pilot study was to determine the difference between the outcome of a single high-dosage extracorporeal shockwave therapy and two sessions of low-dosage extracorporeal shockwave therapy.
This study compared a single high-level middle-energetic extracorporeal shockwave therapy (0.3 mJ/mm(2)) with a low-level middle-energetic extracorporeal shockwave therapy applied twice in a weekly interval (0.2 mJ/mm(2)). Thirty patients that suffered from calcifying tendinitis for at least 6 months received navigated, fluoroscopy-guided extracorporeal shockwave therapy. The gain of Constant Murley Score, Visual Analogue Scale during state of rest and weight-bearing situations ("stress") and radiographic progress was documented 6 and 12 weeks after therapy.
In both groups, a significant reduction in pain during stress and improvement of function was observed. In contrast, no significant reduction in pain during rest was observed. No significant difference between both groups concerning reduction in the calcific deposit after 6 weeks was detected. Group B showed minor advantages in radiographical improvement after 12 weeks. In 36% of the patients, the calcific deposit completely dissoluted after 12 weeks.
This pilot study indicates that a single high-level extracorporeal shockwave therapy may be as effective as two applications of a lower-dosed extracorporeal shockwave therapy for calcifying tendinitis. An effective single-session strategy could reduce treatment time, material costs and healthcare expenses and ionizing radiation in case of fluoroscopy guidance.
肩袖钙化性肌腱炎的体外冲击波治疗策略在治疗次数和剂量方面存在差异。本前瞻性初步研究旨在确定单次高剂量体外冲击波治疗与两次低剂量体外冲击波治疗结果的差异。
本研究比较了单次高能中剂量体外冲击波治疗（0.3 mJ/mm²）与每周间隔应用两次低能中剂量体外冲击波治疗（0.2 mJ/mm²）的效果。30 例患有钙化性肌腱炎至少 6 个月的患者接受了导航、透视引导下的体外冲击波治疗。治疗后 6 周和 12 周时，记录Constant Murley 评分、静息和负重状态下（“压力”）视觉模拟量表（VAS）的改善情况以及影像学进展。
两组患者的压力下疼痛和功能均有显著改善。相反，静息时的疼痛无明显减轻。两组患者在治疗 6 周后钙化沉积物减少方面无显著差异。B 组在治疗 12 周后在影像学改善方面有轻微优势。12 周后，36%的患者钙化沉积物完全溶解。
本初步研究表明，单次高能体外冲击波治疗可能与两次低剂量体外冲击波治疗对钙化性肌腱炎同样有效。单次治疗策略可减少治疗时间、材料成本和医疗费用，并减少透视引导下的电离辐射。
