Department for Orthopaedics and Orthopaedic Surgery, Vienna Medical School, AKH-Wien/Orthopädie, Währinger Gürtel 18-20, 1090, Vienna, Austria,
Arch Orthop Trauma Surg. 2014 May;134(5):651-6. doi: 10.1007/s00402-014-1927-6. Epub 2014 Feb 1.
During arthroscopy, the localization of calcific deposit in patients suffering from calcifying tendinitis can be demanding and time consuming, frequently using ionizing radiation. Intraoperative ultrasound has been recently promoted, facilitating deposit localization and reducing radiation dose.
In this prospective, randomized, controlled and clinical observer-blinded pilot trial, 20 patients with calcific tendinitis were operated. In group I, the deposit was localized conventionally. In group II, the deposit was localized using intraoperative ultrasound. The needle punctures to detect the deposit and operation times were noted. Patients were postoperatively evaluated after 2 and 6 weeks and 9 months.
In group II, the needle punctures to detect the deposit were significantly lower than in group I (p < 0.0001). Operation time to localize the deposit was also significantly less in group II (p < 0.033). In both groups, patients improved significantly with increased shoulder function (p < 0.0001) and decreased pain (p < 0.0001) 2 weeks and 9 months (p < 0.001) after surgery. The difference between the groups was not significant. Excellent radiological findings were obtained in both groups after 9 months.
Intraoperative US significantly facilitates the detection of calcific deposits during arthroscopic debridement by speeding up surgery and reducing the number of needle punctures. Hence, we have changed our method of detecting calcific deposits intraoperatively from fluoroscopy to ultrasound.
在关节镜检查中，患有钙化性肌腱炎的患者的钙化沉积物定位既具有挑战性又耗时，且通常需要使用电离辐射。术中超声最近得到了推广，有利于沉积物的定位并减少辐射剂量。
在这项前瞻性、随机、对照和临床观察者盲法的初步试验中，对 20 例钙化性肌腱炎患者进行了手术。在第 I 组中，常规定位沉积物。在第 II 组中，使用术中超声定位沉积物。记录检测沉积物的针穿刺次数和手术时间。患者在术后 2 周、6 周和 9 个月时进行术后评估。
在第 II 组中，检测沉积物的针穿刺次数明显少于第 I 组（p<0.0001）。定位沉积物的手术时间也明显缩短（p<0.033）。在两组中，患者的肩部功能均明显改善（p<0.0001），疼痛明显减轻（p<0.0001），术后 2 周和 9 个月（p<0.001）。两组之间的差异无统计学意义。两组患者在术后 9 个月时均获得了良好的影像学结果。
术中超声显著加快了手术速度，减少了针穿刺次数，从而更有利于关节镜下清创术中钙化沉积物的检测。因此，我们已经将术中检测钙化沉积物的方法从透视检查改为超声检查。
