Lee Tae Kyoung, Shin Sang Jin
Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Clin Shoulder Elb. 2018 Jun 1;21(2):75-81. doi: 10.5397/cise.2018.21.2.75. eCollection 2018 Jun.
We investigated the resolution of pain and functional recovery of shoulder after arthroscopic removal of calcific deposits in patients with chronic calcific tendinitis.
We enrolled 39 patients who were treated arthroscopically for chronic calcific tendinitis that had been non-responsive to at least 6 months of conservative treatment. We evaluated clinical outcome in terms of the American Shoulder Elbow Surgeons (ASES), the Constant score, the visual analogue score (VAS) for pain. We used plain radiography to measure the size of the calcific deposits. We also analyzed the clinical outcomes in terms of whether or not a cuff repair was performed or the degree of removal of calcific deposits.
We found that complete resolution of pain took on average 5.7 months after the arthroscopic treatment. The ASES and the Constant score significantly improved from the 3-month follow-up, however it took 6 months until the scores reached on average 80 points or above. We found that these clinical outcomes at the final follow-up did not significantly differ by whether or not cuff repair was performed. Similarly, we found that the clinical outcomes did not significantly differ by the degree of calcium removal.
We found that arthroscopic removal of calcification leads to improved clinical outcomes in patients with chronic calcific tendinitis. However, our findings show it takes at least 6 months for the clinical improvement to become statistically significant. We also found that concomitant cuff repairs or the degree of removal of calcification does not affect the clinical outcome of the arthroscopic treatment.
我们研究了慢性钙化性肌腱炎患者在关节镜下清除钙化沉积物后肩部疼痛的缓解情况及功能恢复情况。
我们纳入了39例经关节镜治疗慢性钙化性肌腱炎的患者，这些患者对至少6个月的保守治疗无反应。我们根据美国肩肘外科医师学会（ASES）评分、Constant评分、疼痛视觉模拟评分（VAS）评估临床结果。我们使用X线平片测量钙化沉积物的大小。我们还根据是否进行了肩袖修复或钙化沉积物的清除程度分析了临床结果。
我们发现关节镜治疗后疼痛完全缓解平均需要5.7个月。ASES评分和Constant评分从3个月随访时开始显著改善，然而，平均需要6个月这些评分才能达到80分或更高。我们发现，在末次随访时，这些临床结果在是否进行肩袖修复方面没有显著差异。同样，我们发现临床结果在钙化清除程度方面也没有显著差异。
我们发现关节镜下清除钙化可使慢性钙化性肌腱炎患者的临床结果得到改善。然而，我们的研究结果表明，临床改善至少需要6个月才能在统计学上具有显著性。我们还发现，同时进行的肩袖修复或钙化清除程度并不影响关节镜治疗的临床结果。
