Ralph Kayser1, Steffen Hampf, Engelbert Seeber, Christoph E Heyde. 1. Klinik fur Unfall- und Wiederherstellungschirurgie, Campus Benjamin Franklin, Zentrum fur spezielle Chirurgie des Bewegungsapparates, Berlin, Germany. ralph.kayser@charite.de
Abstract
PURPOSE: The objective of our study was to evaluate whether preoperative ultrasound-guided marking of calcium deposits has a positive effect on the efficiency and speed of localization of calcium deposits during surgery, and whether this technique is a factor that increases the probability of good clinical results. METHODS:Twenty-four patients who required surgery for calcific tendinitis in the years 2001 and 2002 were divided into 2 groups of 12 patients by week. Before undergoing surgery, those in group 1 (weeks 1, 3, 5, etc.) were given a standard ultrasound examination, along with preoperative ultrasound-guided marking (pre-USM) of calcium deposits, whereas group 2 (weeks 2, 4, 6, etc.) received the standard ultrasound examination without pre-USM. In both groups, arthroscopic removal of calcium deposits was carried out and the postoperative treatment plan was identical. The clinical result was evaluated by the Constant-Murley score. RESULTS: At the 6-week and 2-year follow-up visits, the clinical result was significantly better (P < .05) in the pre-USM group than in the unmarked group (Constant score of 76 v 70 points and 80 v 74 points, respectively). After 12 weeks, the clinical outcomes of both groups showed an approaching significance, with better results seen in the pre-USM group (79 v 74 points; P = .052). The time required for intraoperative localization of calcium deposits was 16 versus 22 minutes. The difference showed an approaching significance (P = .057). Removal of calcium was possible in 12 versus 10 cases; complete removal was possible in 8 versus 6 cases, respectively. However, none of these variables had a statistically significant influence on our results. CONCLUSIONS: Preoperative ultrasound-guided marking of calcific deposits is a procedure that statistically significantly improves the clinical results of arthroscopic surgery as seen at 6 weeks and 2 years; statistical significance of .052 was approached only at 12 weeks, as we have shown here for calcifying tendinitis of the shoulder joint. LEVEL OF EVIDENCE: Level III, development of diagnostic criteria with nonconsecutive patients.
RCT Entities:
PURPOSE: The objective of our study was to evaluate whether preoperative ultrasound-guided marking of calcium deposits has a positive effect on the efficiency and speed of localization of calcium deposits during surgery, and whether this technique is a factor that increases the probability of good clinical results. METHODS: Twenty-four patients who required surgery for calcific tendinitis in the years 2001 and 2002 were divided into 2 groups of 12 patients by week. Before undergoing surgery, those in group 1 (weeks 1, 3, 5, etc.) were given a standard ultrasound examination, along with preoperative ultrasound-guided marking (pre-USM) of calcium deposits, whereas group 2 (weeks 2, 4, 6, etc.) received the standard ultrasound examination without pre-USM. In both groups, arthroscopic removal of calcium deposits was carried out and the postoperative treatment plan was identical. The clinical result was evaluated by the Constant-Murley score. RESULTS: At the 6-week and 2-year follow-up visits, the clinical result was significantly better (P < .05) in the pre-USM group than in the unmarked group (Constant score of 76 v 70 points and 80 v 74 points, respectively). After 12 weeks, the clinical outcomes of both groups showed an approaching significance, with better results seen in the pre-USM group (79 v 74 points; P = .052). The time required for intraoperative localization of calcium deposits was 16 versus 22 minutes. The difference showed an approaching significance (P = .057). Removal of calcium was possible in 12 versus 10 cases; complete removal was possible in 8 versus 6 cases, respectively. However, none of these variables had a statistically significant influence on our results. CONCLUSIONS: Preoperative ultrasound-guided marking of calcific deposits is a procedure that statistically significantly improves the clinical results of arthroscopic surgery as seen at 6 weeks and 2 years; statistical significance of .052 was approached only at 12 weeks, as we have shown here for calcifying tendinitis of the shoulder joint. LEVEL OF EVIDENCE: Level III, development of diagnostic criteria with nonconsecutive patients.
Authors: M Sabeti-Aschraf; C Gonano; E Nemecek; L Cichocki; C Schueller-Weidekamm Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-08-20 Impact factor: 4.342