Moggio Lucrezia, Marotta Nicola, de Sire Alessandro, Benedetto Giorgia Lucia, Gasparini Giorgio, Ammendolia Antonio, Parrotta Elvira Immacolata, Mercurio Michele
Rehabilitation Unit, Ospedale Degli Infermi, Biella, Italy.
Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG, Magna Graecia University, Catanzaro, Italy.
Orthop Surg. 2025 Nov;17(11):3048-3066. doi: 10.1111/os.70175. Epub 2025 Sep 26.
Rotator cuff calcific tendinopathy is a leading cause of nontraumatic shoulder pain, frequently leading to articular and functional impairments, depicting an adhesive capsulitis-like clinical presentation. To date, there is a lack of evidence on the impact of conservative approaches, and no gold standard has been established for managing rotator cuff calcific tendinopathy. This systematic review aimed to identify the most effective conservative approach for reducing pain and improving function in rotator cuff calcific tendinopathy patients.
PubMed, Scopus, and Cochrane Library databases were systematically searched from their inception until January 2, 2025, for English-language randomized clinical trials including adults affected by rotator cuff calcific tendinopathy undergoing conservative treatment. Data extraction was performed independently by two reviewers using a customized data extraction form, with consensus reached by a third reviewer. A network meta-analysis was subsequently carried out to compare the efficacy of different interventions. The risk of bias within the included randomized clinical trials was assessed using Version 2 of the Cochrane risk-of-bias tool for randomized trials. The study has been registered with PROSPERO, registration number CRD420250650833.
Nineteen articles were included. This study identified 1160 subjects affected by rotator cuff calcific tendinopathy. A pairwise comparison through a network meta-analysis indicated that platelet-rich plasma exhibited the highest probability (85%) of improving shoulder function, followed by disodium ethylenediamine tetra-acetic acid at 75%, aspiration techniques at 65%, and extracorporeal shockwave therapy at 57%. Regarding pain reduction, disodium ethylenediamine tetra-acetic acid showed the highest probability (66%), followed by kinesiotaping and needle aspiration, both at 61%.
This systematic review and network meta-analysis identified several interventional techniques, including platelet-rich plasma and disodium ethylenediamine tetra-acetic acid injections, extracorporeal shockwave therapy, and needle aspiration, as more effective strategies for reducing pain and improving function in subjects affected by rotator cuff calcific tendinopathy.
I (systematic review of Level-I randomized controlled studies).
肩袖钙化性肌腱病是非创伤性肩部疼痛的主要原因，常导致关节和功能障碍，呈现出类似肩周炎的临床表现。迄今为止，关于保守治疗方法的影响缺乏证据，且尚未建立治疗肩袖钙化性肌腱病的金标准。本系统评价旨在确定减轻肩袖钙化性肌腱病患者疼痛和改善功能的最有效保守治疗方法。
对PubMed、Scopus和Cochrane图书馆数据库从建库至2025年1月2日进行系统检索，查找纳入接受保守治疗的肩袖钙化性肌腱病成年患者的英文随机临床试验。两名评价员使用定制的数据提取表独立进行数据提取，第三名评价员达成共识。随后进行网络荟萃分析以比较不同干预措施的疗效。使用Cochrane随机试验偏倚风险工具第2版评估纳入的随机临床试验中的偏倚风险。该研究已在PROSPERO注册，注册号为CRD420250650833。
纳入19篇文章。本研究确定了1160例肩袖钙化性肌腱病患者。通过网络荟萃分析进行的成对比较表明，富血小板血浆改善肩部功能的概率最高（85%），其次是乙二胺四乙酸二钠，为75%，抽吸技术为65%，体外冲击波治疗为57%。在减轻疼痛方面，乙二胺四乙酸二钠的概率最高（66%），其次是肌内效贴和针吸，均为61%。
本系统评价和网络荟萃分析确定了几种干预技术，包括富血小板血浆和乙二胺四乙酸二钠注射、体外冲击波治疗和针吸，是减轻肩袖钙化性肌腱病患者疼痛和改善功能的更有效策略。
I（I级随机对照研究的系统评价）
