Moya Daniel, Rashid Mustafa, Rowinski Sergio, Al-Qahtani Saad, Bernáldez Domínguez Pedro, Gómez Diego, Dallo Ignacio
Department of Orthopedic Surgery, Hospital Británico de Buenos Aires, C1280 AEB, Argentina.
Manchester University NHS Foundation Trust, Manchester M13 9WL, United Kindom.
SICOT J. 2025;11:9. doi: 10.1051/sicotj/2025003. Epub 2025 Feb 20.
There are many variables that influence the decision-making process in the treatment of rotator cuff calcifications. The stage of the deposit, prognostic factors, previous failed treatments, pain level, and functional disability must all be considered. The tendency for spontaneous resolution is an important reason to always exhaust conservative treatment, being non-invasive options the first line of treatment. The emergence of focused shock wave therapy offered a powerful tool for the non-invasive management of rotator cuff calcifications. High-energy focused shock waves have a high degree of recommendation for the treatment of rotator cuff calcifications, supported by meta-analyses and systematic reviews. If non-invasive techniques fail, there is the possibility of moving to a minimally invasive procedure such as ultrasound-guided barbotage. Finally, classic invasive techniques are also a frequent indication, including open surgery and arthroscopy. As each treatment has advantages and disadvantages, the most advisable strategy is to progress from the least invasive therapeutic methods to the most invasive ones without losing sight of the clinical stage of the disease and the general context of each patient.
有许多变量会影响肩袖钙化治疗中的决策过程。必须考虑沉积物的阶段、预后因素、先前失败的治疗、疼痛程度和功能障碍。自发溶解的倾向是始终采用保守治疗的一个重要原因，非侵入性选择是一线治疗方法。聚焦冲击波疗法的出现为肩袖钙化的非侵入性治疗提供了一个强大的工具。高能聚焦冲击波在治疗肩袖钙化方面有很高的推荐度，这得到了荟萃分析和系统评价的支持。如果非侵入性技术失败，可以考虑转向微创程序，如超声引导下的灌洗术。最后，经典的侵入性技术也是常见的治疗选择，包括开放手术和关节镜检查。由于每种治疗都有优缺点，最明智的策略是从侵入性最小的治疗方法逐步过渡到侵入性最大的方法，同时不忽视疾病的临床阶段和每个患者的总体情况。
