Orthopaedic Department, Medical College Affiliated Hospital of Chinese People's Armed Police Force, Tianjin, China.
Ultrasound Med Biol. 2012 May;38(5):727-35. doi: 10.1016/j.ultrasmedbio.2012.01.024. Epub 2012 Mar 16.
Long bicipital tenosynovitis is regarded as one of the common causes of shoulder pain and dysfunction. The traditional therapeutic approach includes a variety of conservative treatments, but these treatments are not substantiated, owing to the lack of proven clinical efficacy. Radial extracorporeal shock wave therapy (rESWT) uses a pneumatically generated and radially propagating low-energy pressure pulse and has been clinically shown to be a new alternative form of treating refractory soft tissue inflammation. While treating patients suffering from long bicipital tenosynovitis, a randomized, controlled trial was conducted to analyze the effects of radial shock wave therapy on pain and function. Seventy-nine adults with long bicipital tenosynovitis were randomized to receive either active (1500 pulses, 8 Hz, 3 bars) or sham treatment through four sessions that were held once a week. All of these adults were assessed before treatment and at time intervals of 1, 3 and 12 months since the completion of the treatment. The outcomes were measured through the visual analogue scale (VAS) and L'Insalata shoulder questionnaire. Mean VAS in the rESWT group showed significant and sustained reduction from 5.67 ± 1.32 at baseline to 2.58 ± 1.49 at one month, 1.83 ± 1.25 at three months and 1.43 ± 0.94 at 12 months from baseline, whereas the sham group's mean VAS was 6.04 ± 0.97 before treatment and stabilized at 5.57 ± 0.84 at 12 months. Similar trends were found for the function scores. Mean scores were increased after rESWT from 60.57 ± 6.91 at baseline to 79.85 ± 6.59 at 1 month and 83.44 ± 5.21 at 12 months from baseline. Both pain and function scores showed significant differences between the two groups (p < 0.001). The rESWT group consisted of "invalid conservative treatment subgroup" and "none conservative treatment subgroup." Both groups showed good recovery and prognosis. Therefore, we recommend rESWT in treating primary long bicipital tenosynovitis.
长肱二头肌肌腱滑膜炎被认为是肩部疼痛和功能障碍的常见原因之一。传统的治疗方法包括各种保守治疗，但这些治疗方法没有得到证实，因为缺乏经过验证的临床疗效。径向体外冲击波疗法（rESWT）使用气动产生的径向传播的低能量压力脉冲，已在临床上证明是治疗难治性软组织炎症的一种新的替代形式。在治疗患有长肱二头肌肌腱滑膜炎的患者时，进行了一项随机对照试验，以分析径向冲击波疗法对疼痛和功能的影响。79 名患有长肱二头肌肌腱滑膜炎的成年人被随机分为主动治疗组（1500 脉冲，8 Hz，3 巴）或假治疗组，每组通过 4 次治疗，每周一次。所有这些成年人在治疗前和治疗后 1、3 和 12 个月进行评估。结果通过视觉模拟量表（VAS）和 L'Insalata 肩部问卷进行测量。rESWT 组的平均 VAS 从基线时的 5.67 ± 1.32 显著持续降低至 1 个月时的 2.58 ± 1.49、3 个月时的 1.83 ± 1.25 和 12 个月时的 1.43 ± 0.94，而假治疗组的平均 VAS 在治疗前为 6.04 ± 0.97，并在 12 个月时稳定在 5.57 ± 0.84。功能评分也出现了类似的趋势。rESWT 后平均得分从基线时的 60.57 ± 6.91 增加至 1 个月时的 79.85 ± 6.59 和 12 个月时的 83.44 ± 5.21。两组之间的疼痛和功能评分均有显著差异（p < 0.001）。rESWT 组包括“无效保守治疗亚组”和“无保守治疗亚组”。两组均有较好的恢复和预后。因此，我们建议使用 rESWT 治疗原发性长肱二头肌肌腱滑膜炎。
