THE  EFFECT OF  EXTRACORPOREAL SHOCK  WAVE THERAPY IN TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF OF THE SHOULDER

Maja Manoleva; Valentina Koevska; Biljana Mitrevska; Marija Gocevska; Cvetanka Gjerakaroska Savevska; Biljana Kalchovska Ivanovska; Liljana Malinovska Nikolovska

Maja Manoleva University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Valentina Koevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Biljana Mitrevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Marija Gocevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Cvetanka Gjerakaroska Savevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Biljana Kalchovska Ivanovska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
Liljana Malinovska Nikolovska AcibademSistina Clinical Hospital, Department of pediatric cardiac surgery, Skopje, R. North Macedonia

Abstract

Calcifying tendinitis of a shoulder is a frequent disorder with an unknown etiology. It is usually treated with different physical therapy modalities where extracorporeal shockwave therapy comes as a new effective method. Objective: to assess the impact of extracorporeal shockwave therapy in the treatment of calcifying tendinitis of the rotator cuff of the shoulder. The study is a prospective, monocentric clinical study involving 13 patients who received extracorporeal shockwave therapy in 5 treatments, applied once a week in one session. The patients were evaluated with a Visual analog scale for pain and measurement of the range of motion of the shoulder joint. Clinical findings were evaluated before starting the treatment with extracorporeal shockwave therapy and at the end of the treatment, 5 weeks later. After the treatment all the patients had statistically significantly better results in the Visual analogue scale for pain and the range of motion in the shoulder joint. Extracorporeal shock wave therapy is a safe and non-invasive treatment that reduces pain and improves range of motion in the treatment of calcifying tendinitis of the rotator cuff.

Keywords: calcifying tendinitis, shoulder, extracorporeal shock wave therapy.

https://doi.org/10.55302/JMS2251163m

References

1. Lang G, Izadpanah K, Kubosch EJ, Maier D, Südkamp N, Ogon P. Examination of concomitant glenohumeral pathologies in patients treated arthroscopically for calcific tendinitis of the shoulder and implications for routine diagnostic joint exploration. BMC Musculoskelet Disord. 2017;18(1):476.
2. Uhthoff HK, Loehr JW. Calcific Tendinopathy of the Rotator Cuff: Pathogenesis, Diagnosis, and Management. J Am Acad Orthop Surg. 1997 Jul;5(4):183-191.
3. Carli А., Pulcinelli F, Rose GD, Pitino D, Ferretti A. Calcific tendinitis of the shoulder. Joints 2014; 2: 130-6.
4. Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol 1989; 3: 567-81.
5. Ogon P, Suedkamp NP, Jaeger M, Izadpanah K, Koestler W, Maier D. Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder. Arthritis Rheum 2009; 60: 2978-84.
6. Maffulli N. Basic science and rotator cuff repair: where have we arrived. Med Sport Sci. 2012;57:8–10.
7. Wu YC, Tsai WC, Tu YK, Yu TY. Comparative Effectiveness of Nonoperative Treatments for Chronic Calcific Tendinitis of the Shoulder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil. 2017;98(8):1678‐1692.
8. Maffulli G, Hemmings S, Maffulli N. Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) For Soft Tissue Injuries (ASSERT): An Online Database Protocol. Transl Med UniSa. 2014;10:46–51.
9. Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, et al. High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg [Br] 2007;89:335–341.
10. Chianca, V., Albano, D., Messina, C., Midiri, F., Mauri, G., Aliprandi, A., Catapano, M., Pescatori, L. C., Monaco, C. G., Gitto, S., Pisani Mainini, A., Corazza, A., Rapisarda, S., Pozzi, G., Barile, A., Masciocchi, C., & Sconfienza, L. M. (2018). Rotator cuff calcific tendinopathy: from diagnosis to treatment. Acta bio-medica : Atenei Parmensis, 89(1-S), 186–196.
11. Wendelboe AM, Hegmann KT, Gren LH, Alder SC, White GL Jr, Lyon JL. Associations between body- mass index and surgery for rotator cuff tendinitis. J Bone Joint Surg [Am] 2004;86:743–747.
12. Sansone V, Maiorano E, Galluzzo A, Pascale V. Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment. Orthop Res Rev. 2018;10:63–72.
13. Huisstede BM, Gebremariam L, van der Sande R, Hay EM, Koes BW. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review. Man Ther. 2011;16:419–433.
14. Cho NS, Lee BG, Rhee YG. Radiologic course of the calcific deposits in calcific tendinitis of the shoulder: does the initial radiologic aspect affect the final results? J Shoulder Elbow Surg. 2010;19(2):267–272.
15. Rebuzzi, E., Coletti, N., Schiavetti, S., and Giusto, F. Arthroscopy surgery versus shockwave therapy for chronic calcifying tendinitis of the shoulder. J. Orthop. Traumatol.2008; 9: 179–185.
16. Berta L, Fazzari A, Ficco AM, Enrica PM, Catalano MG, Frairia R. Extracorporeal Shock Wave enhance normal fibroblast proliferation in vitro and activate mRNA expression for TGF-β1 and for collagen types I and III. Acta Orthop. 2009;80(5):612–617.
17. Brañes J, Conteras HR, Cabello P, Antonic V, Guiloff LJ, Brannes M. Shoulder rotator cuff responses to extracorporeal shockwave therapy: morphological and immunohistochemical analysis. Shoulder Elbow. 2012;4(3):163–168.
18. Chou WY, Wang CJ, Wu KT, Yang YJ, Ko JY, Siu KK. Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder. Bone Joint J. 2017;99:1643–1650.
19. Huisstede BM, Gebremariam L, van der Sande R, Hay EM, Koes BW. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review. Man Ther. 2011;16:419–433.
20. Cacchio, A., Paoloni, M., Barile, A., Don, R., de Paulis, F., Calvisi, V., Ranavolo, A., Frascarelli, M., Santilli, V., Spacca, G. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study. Phys. Ther. 2006;86:672–68.
21. Pleiner J, Crevenna R, Langenberger H, Keilani M, Nuhr M, Kainberger F, et al. Extracorporeal shockwave treatment is effective in calcific tendinitis of the shoulder. A randomized controlled trial. Wien Klin Wochenschr. 2004;116:536–541.
22. Malliaropoulos, N., Thompson, D., Meke, M., Pyne, D., Alaseirlis, D., Atkinson, H., Korakakis, V., & Lohrer, H. (2017). Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study. BMC musculoskeletal disorders, 18(1), 513.
23. Wang, C.J., Yang, K.D., Wang, F.S., Chen, H.H., Wang, J.W. Shock wave therapy for calcific tendinitis of the shoulder: a prospective clinical study with two-year follow-up. Am. J. Sports Med. 2003;31:425–426.