De Grandis Andrea, D'Alessandro Carlo, Sussan Giovanni, Crimì Alberto, Tognolo Lucrezia, Coraci Daniele, Masiero Stefano, Ragazzi Roberto, Quaia Emilio, Crimì Filippo
Institute of Radiology, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Orthopedics and Orthopedic Oncology Unit, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Life (Basel). 2025 Aug 16;15(8):1302. doi: 10.3390/life15081302.
Ultrasound-guided percutaneous interventions are well-established as effective treatments for shoulder calcific tendinopathy. In this work, we modified the conventional double-needle approach by incorporating a closed-circuit irrigation system and assessed the procedure's clinical and radiological outcomes. We enrolled prospectively 24 patients (10 males; median age 54 years, IQR: 50-62) with painful calcific tendonitis of the shoulder between October 2023 and March 2024. All patients had a calcification > 5 mm treated with ultrasound-guided closed-circuit irrigation. Radiography, ultrasound evaluation, and OSS and SPADI clinical questionnaires were administered before the treatment and 3 months after. After the procedure, there was a significant reduction in the size of the calcifications (12 mm, IQR: 10-20 mm vs. 5.5 mm, IQR: 2-10 mm; < 0.001). After the procedure, none of the patients experienced infections, while two developed bursitis. Three months after the procedure there were significant improvement in the OSS (16.5, IQR: 10-23 vs. 32, IQR: 36-45.5; < 0.0001) and reduction in SPADI scores: pain (88, IQR: 74-95 before vs. 13, IQR: 4-24; < 0.0001), disability (72, IQR: 60-90 before vs. 8, IQR: 4-20; < 0.0001), and total score (78, IQR: 66-91 before vs. 11, IQR: 4-20; < 0.0001). The closed-circuit double-needle irrigation for calcific tendinopathy of the shoulder is an effective treatment that improves both shoulder pain and function with a very low risk of short-term complications.
超声引导下经皮介入治疗已被公认为是治疗肩部钙化性肌腱炎的有效方法。在本研究中，我们通过引入闭路冲洗系统对传统双针方法进行了改良，并评估了该手术的临床和影像学结果。我们前瞻性地纳入了2023年10月至2024年3月期间24例肩部疼痛性钙化性肌腱炎患者（10例男性；中位年龄54岁，四分位间距：50 - 62岁）。所有患者均接受了超声引导下闭路冲洗治疗钙化灶直径>5 mm的患者。在治疗前和治疗后3个月进行了X线摄影、超声评估以及OSS和SPADI临床问卷评估。手术后，钙化灶大小显著减小（12 mm，四分位间距：10 - 20 mm vs. 5.5 mm，四分位间距：2 - 10 mm；<0.001）。术后，患者均未发生感染，2例发生了滑囊炎。术后3个月，OSS评分显著改善（16.5，四分位间距：10 - 23 vs. 32，四分位间距：36 - 45.5；<0.0001），SPADI评分降低：疼痛（术前88，四分位间距：74 - 95 vs. 术后13，四分位间距：4 - 24；<0.0001）、功能障碍（术前72，四分位间距：60 - 90 vs. 术后8，四分位间距：4 - 20；<0.0001）以及总分（术前78，四分位间距：66 - 91 vs. 术后11，四分位间距：4 - 20；<0.0001）。肩部钙化性肌腱炎的闭路双针冲洗是一种有效的治疗方法，可改善肩部疼痛和功能，且短期并发症风险极低。
