Interventional Rotator Cuff Treatment Provides Immediate Relief

A minimally invasive procedure to treat shoulder tendonitis provides immediate symptom relief to the patient, according to a study published in the July issue of Radiology. The study found that ultrasound-guided, nonsurgical therapy significantly reduces pain from calcific tendonitis of the rotator cuff and restores lasting mobility after treatment.
 
“With this treatment, we were able to establish a single, inexpensive, and effective treatment for calcific tendonitis of the rotator cuff. This has never happened before,” says coauthor Luca M. Sconfienza, MD, from the Unit of Radiology, IRCCS Policlinico San Donato, University of Milan School of Medicine in Italy. “Symptoms improved in patients treated with our procedure compared to nontreated patients.
 
Calcific tendonitis causes the formation of small calcium deposits within the tendons of the rotator cuff. It is most common in adults in their 40s. In most cases, the deposits become painful and can restrict mobility. In minor cases, physical therapy or anti-inflammatory medications may be sufficient to address the problem until the calcifications break apart spontaneously. In severe cases, patients may require shockwave treatment or open surgery to remove the calcium. Open surgery requires a hospital stay and rehabilitation and, on rare occasions, may result in major complications, such as tendon rupture.
 
“This treatment could completely replace other treatments that are affected by several limitations and complications,” Sconfienza says.
 
Ultrasound-guided percutaneous therapy represents an effective and inexpensive alternative to surgery that is less stressful for the patient. For the 20-minute procedure, the shoulder is anesthetized and, with ultrasound guidance, a radiologist injects a saline solution into the rotator cuff to wash the area and break up the calcium. A second needle is used to aspirate, or withdraw, the calcium residue. Recovery time is about an hour.
 
“People with calcific tendonitis should know that with a simple, one-time, ultrasound-guided procedure, they could recover completely from the terrible pain constantly affecting their shoulder,” Sconfienza says.
 
For the study, Sconfienza, senior author Giovanni Serafini, MD, from the radiology unit at Santa Corona Hospital in Pietra Ligure, Italy, and colleagues used ultrasound-guided percutaneous therapy to treat 235 shoulders in 133 women and 86 men (mean age 42) with calcific tendonitis. An additional 68 patients (31 men and 37 women) did not receive treatment and acted as a control group. All of the patients had shoulder pain that was unresponsive to previous medical treatment. Follow-up was conducted after one month, three months, one year, five years, and 10 years.
 
The results showed that treated patients exhibited a considerable reduction in pain and significant improvement to mobility of the affected limb after one month, three months, and one year compared to nontreated patients. Five and 10 years after the procedure, the condition of nontreated patients had improved to the point that reported outcomes were similar to those of the treated group. While few institutions currently offer this therapy, Sconfienza says that, theoretically, the procedure could be performed in any hospital or clinic that has ultrasound equipment with a superficial probe.
 
“There are millions of people in the world affected by calcific tendonitis,” says Sconfienza. “This treatment can provide quick and inexpensive relief for all of them.”
 
— Source: Radiological Society of North America