Long-term effects of extracorporeal shockwave therapy in chronic calcific tendinitis of the shoulder.

Various short-term studies have demonstrated the effectiveness of extracorporeal shockwave therapy in the treatment of calcific tendinitis. To evaluate the long-term effects and any complications, the 4-year outcome was determined in a prospective study of 115 patients. One session (group A, n = 56) or two sessions (group B, n = 59) of high-energy shockwave therapy were administered to each patient. The 6-month results showed that the level of success achieved in pain relief and the Constant score was energy-dependent and that there were significant differences in radiologic changes between the groups. By 4 years after shockwave therapy, 20% of the entire patient population had undergone surgery on the involved shoulder. The effects of extracorporeal shockwave therapy not followed by any other therapy within the first 6 months were evaluated in 59% (n = 68) of the original 115 patients. Subjectively, 78% of patients in group A and 87% in group B thought the shockwave treatment had been successful. The Constant score increased from a mean of 45 before treatment to 88 in group A and 85 in group B after treatment. Radiologic changes were found in 93% of patients in each group. In conclusion, the failure rate after ESWT is high, but for 70% of the patients in this study, the treatment was successful and no long-term complications were seen.