Werry W Doug, Hedeman Margaret, Sharma Arnav, Garfi John, Elentuck Dmitry, Samuelsen Brian, Kasparyan George, Lemos Mark
Tufts University School of Medicine, Boston, MA, USA.
Yale University, New Haven, CT, USA.
JSES Int. 2024 Jun 19;8(5):1039-1044. doi: 10.1016/j.jseint.2024.06.005. eCollection 2024 Sep.
Rotator cuff calcific tendinitis is a common cause of shoulder discomfort. Ultrasound-guided barbotage consists of needle aspiration and a subsequent lavage of calcium deposits in the shoulder. While barbotage has proven benefit, other options have also shown similar symptom improvement. This study aims to examine pain outcomes of patients following barbotage of calcific tendinitis. We hypothesize that barbotage will improve shoulder pain scores compared to preprocedure scores.
This is a retrospective chart review of 179 ultrasound-guided barbotage interventions for calcific tendinitis of the rotator at a New England urban medical center. Patient pain scores were analyzed using a Friedman's analysis of variance at a significance level of α = 0.05, and statistical significance between groups was elucidated using nonparametric post-hoc tests of significance between groups.
Pain scores at preprocedure, 2-month, 6-month, and 12-month follow-ups yielded significant differences. Post-hoc nonparametric analysis revealed pain scores at 2 months were significantly lower than preprocedure and at 6 months. Additionally, 47.5% of cases in this study went on to require a secondary procedure of the respective shoulder after their barbotage treatment.
Upon analysis, utilization of barbotage as a treatment for calcific tendonitis of the shoulder appears to produce notable pain reduction in the short term (specifically at the 2-month follow-up), but begins to lose some efficacy over long-term evaluation. Additionally, a large portion of patients required further interventions of their shoulder, including corticosteroid injections, more barbotage, or surgery, raising further concerns over its long-term benefit.
肩袖钙化性肌腱炎是肩部不适的常见原因。超声引导下灌洗术包括针吸以及随后对肩部钙沉积物的冲洗。虽然灌洗术已被证明有益，但其他方法也显示出类似的症状改善。本研究旨在检查钙化性肌腱炎患者接受灌洗术后的疼痛结果。我们假设与术前评分相比，灌洗术将改善肩部疼痛评分。
这是一项对新英格兰城市医疗中心179例超声引导下肩袖钙化性肌腱炎灌洗术干预的回顾性病历审查。使用弗里德曼方差分析在α = 0.05的显著性水平下分析患者疼痛评分，并使用组间非参数事后显著性检验阐明组间的统计学显著性。
术前、2个月、6个月和12个月随访时的疼痛评分存在显著差异。事后非参数分析显示，2个月时的疼痛评分显著低于术前和6个月时。此外，本研究中47.5%的病例在灌洗治疗后需要对相应肩部进行二次手术。
经分析，将灌洗术用作肩部钙化性肌腱炎的治疗方法似乎在短期内（特别是在2个月随访时）能显著减轻疼痛，但在长期评估中开始失去一些疗效。此外，很大一部分患者需要对其肩部进行进一步干预，包括注射皮质类固醇、更多的灌洗术或手术，这引发了对其长期益处的进一步担忧。
