Nicholas D Clement1, Adam C Watts2, Christine Phillips3, Julie M McBirnie3. 1. Royal Infirmary of Edinburgh, Little France, United Kingdom. Electronic address: nickclement@doctors.org.uk. 2. Wrightington Hospital, Appley Bridge, Wigan, United Kingdom. 3. Shoulder Unit, Royal Infirmary of Edinburgh, Little France, United Kingdom.
Abstract
PURPOSE: To conduct a prospective randomized controlled trial to assess whether arthroscopic bursectomy and debridement of the calcific deposit, with or without subacromial decompression, influences the functional outcome of patients with calcific tendonitis. METHODS: During a 4-year period, 80 patients were recruited who presented to the study center with refractory calcific tendonitis of the shoulder. Forty patients were randomized to have a subacromial decompression, and 40 were randomized not to have a subacromial decompression in combination with bursectomy and arthroscopic removal of the calcific deposit. All surgery was performed by one surgeon who was blinded to the functional assessment of the patients. Patient demographics, body mass index (BMI), and length of symptoms were recorded at the time of randomization. Patients were asked to complete a pain visual analog score (VAS), short form (SF-12), disability arm shoulder and hand (DASH), and Constant score (CS) preoperatively and at 1 year postoperatively. RESULTS: There were 21 male and 59 female patients with a mean age of 49 (range, 32 to 75) years. The mean time of follow-up was 13 (range, 12 to 15) months. There were no significant differences in gender, age, BMI, length of symptoms, or preoperative outcome measures assessed between the groups. Overall, for both groups there was a significant improvement in the pain VAS (P < .001), DASH (P < .001), and CS (P < .001) at 1 year compared with preoperative scores. There were no significant differences demonstrated between the groups for improvement in the pain VAS (P = .57), DASH (P = .93), SF-12 physical component score (P = .58), or CS (P = .27) at 1 year. CONCLUSIONS: This study has demonstrated that the short-term functional outcome of patients with calcific tendonitis after arthroscopic bursectomy and debridement of the calcific deposit is not influenced if performed in combination with or without a subacromial decompression. LEVEL OF EVIDENCE: Level I therapeutic study, randomized controlled trial.
RCT Entities:
PURPOSE: To conduct a prospective randomized controlled trial to assess whether arthroscopic bursectomy and debridement of the calcific deposit, with or without subacromial decompression, influences the functional outcome of patients with calcific tendonitis. METHODS: During a 4-year period, 80 patients were recruited who presented to the study center with refractory calcific tendonitis of the shoulder. Forty patients were randomized to have a subacromial decompression, and 40 were randomized not to have a subacromial decompression in combination with bursectomy and arthroscopic removal of the calcific deposit. All surgery was performed by one surgeon who was blinded to the functional assessment of the patients. Patient demographics, body mass index (BMI), and length of symptoms were recorded at the time of randomization. Patients were asked to complete a pain visual analog score (VAS), short form (SF-12), disability arm shoulder and hand (DASH), and Constant score (CS) preoperatively and at 1 year postoperatively. RESULTS: There were 21 male and 59 female patients with a mean age of 49 (range, 32 to 75) years. The mean time of follow-up was 13 (range, 12 to 15) months. There were no significant differences in gender, age, BMI, length of symptoms, or preoperative outcome measures assessed between the groups. Overall, for both groups there was a significant improvement in the pain VAS (P < .001), DASH (P < .001), and CS (P < .001) at 1 year compared with preoperative scores. There were no significant differences demonstrated between the groups for improvement in the pain VAS (P = .57), DASH (P = .93), SF-12 physical component score (P = .58), or CS (P = .27) at 1 year. CONCLUSIONS: This study has demonstrated that the short-term functional outcome of patients with calcific tendonitis after arthroscopic bursectomy and debridement of the calcific deposit is not influenced if performed in combination with or without a subacromial decompression. LEVEL OF EVIDENCE: Level I therapeutic study, randomized controlled trial.
Authors: Neal L Millar; Karin G Silbernagel; Kristian Thorborg; Paul D Kirwan; Leesa M Galatz; Geoffrey D Abrams; George A C Murrell; Iain B McInnes; Scott A Rodeo Journal: Nat Rev Dis Primers Date: 2021-01-07 Impact factor: 52.329
Authors: Mika Paavola; Antti Malmivaara; Simo Taimela; Kari Kanto; Jari Inkinen; Juha Kalske; Ilkka Sinisaari; Vesa Savolainen; Jonas Ranstam; Teppo L N Järvinen Journal: BMJ Date: 2018-07-19