Rossetti Adrien, Martinel Vincent, Raoul Thomas, Herve Anthony
Department of Orthopedic Surgery, Pontchaillou University Hospital of Rennes, Rennes, France.
Orthopedic Group Ormeau Pyrénées, Polyclinique de l'Ormeau, ELSAN, Tarbes, France.
JSES Int. 2024 Jun 14;8(5):1029-1032. doi: 10.1016/j.jseint.2024.06.001. eCollection 2024 Sep.
Martinel et al described an intraoperative ultrasound technique to easier identify calcification (CA) under arthroscopy. Our hypothesis was that intraoperative ultrasound monitoring allowed better evacuation of calcific tendinopathy. Our aim was to determine whether ultrasound monitoring improved the short-term clinical and radiological outcomes of calcific tendinopathy.
A prospective, single-center, single-operator, consecutive study conducted between February 2020 and June 2023. The inclusion criterion was surgical treatment for evacuation of symptomatic macro-centimetric CA type A or B. The first 20 patients were operated on using the standard surgical technique and the next 20 under ultrasound control. The mean age at surgery was 49.8 years (minimum: 28 years; maximum: 64 years). Patients were reviewed at 6 weeks and 3 months. The evacuation of the CA was checked at 6 weeks by X-ray.
In the standard technique group, the mean preoperative Constant score was 41.4/100 (±15.07). Postoperatively, the Constant score was 58.88/100 (±15.28) at 6 weeks and 69.16/100 (±13.86) at 3 months. The mean preoperative Subjective Shoulder Value (SSV) was 39.0% (±18.61). Postoperatively, the SSV was 64.0% (±17.21) at 6 weeks and 79.47% (±16.06) at 3 months. In the ultrasound control group, the preoperative Constant score was 44.48/100 (±14.28) and 58.18/100 (±15.64) at 6 weeks and 66.87/100 (±18.45) at 3 months postoperatively. The mean preoperative SSV was 40.0% (±16.54) and 61.75% (±18.59) at 6 weeks and 76.05% (±19.62) at 3 months postoperatively. There was no significant postoperative difference in Constant score ( = .732) or SSV ( = .566) between the 2 groups. There was a significant difference ( = .004) between the 2 groups in terms of complete evacuation of the CA with the standard technique in 65% of cases (13 patients out of 20) and with intraoperative ultrasound monitoring in 95% of cases (19 patients out of 20).
There was no significant postoperative difference in Constant score and SSV between the 2 groups in the short term. Evacuation of calcification was significantly better with ultrasound monitoring.
马蒂内尔等人描述了一种术中超声技术，以便在关节镜检查时更轻松地识别钙化（CA）。我们的假设是术中超声监测能更好地清除钙化性肌腱炎。我们的目的是确定超声监测是否能改善钙化性肌腱炎的短期临床和放射学结果。
于2020年2月至2023年6月进行了一项前瞻性、单中心、单操作者、连续性研究。纳入标准为对有症状的A型或B型大厘米级CA进行手术清除。前20例患者采用标准手术技术进行手术，接下来的20例在超声引导下进行手术。手术时的平均年龄为49.8岁（最小：28岁；最大：64岁）。在6周和3个月时对患者进行复查。在6周时通过X线检查CA的清除情况。
在标准技术组中，术前平均Constant评分是41.4/100（±15.07）。术后，6周时Constant评分为58.88/100（±15.28），3个月时为69.16/100（±13.86）。术前平均主观肩关节值（SSV）为39.0%（±18.61）。术后，6周时SSV为64.0%（±17.21），3个月时为79.47%（±16.06）。在超声引导组中，术前Constant评分为44.48/100（±14.28），术后6周时为58.18/100（±15.64），3个月时为66.87/100（±18.45）。术前平均SSV为40.0%（±16.54），术后6周时为61.75%（±18.59），3个月时为76.05%（±19.62）。两组之间术后Constant评分（P = 0.732）或SSV（P = 0.566）无显著差异。两组在CA完全清除方面存在显著差异（P = 0.004），标准技术组65%的病例（20例中的13例）能完全清除，术中超声监测组95%的病例（20例中的19例）能完全清除。
短期内两组之间术后Constant评分和SSV无显著差异。超声监测下钙化的清除情况明显更好。
