Matches in SemOpenAlex for { <https://semopenalex.org/work/W4366245622> ?p ?o ?g. }
- W4366245622 endingPage "1760" @default.
- W4366245622 startingPage "1746" @default.
- W4366245622 abstract "Background Calcific tendinitis is a relatively common shoulder disorder, with 7%-17% of individuals with shoulder pain having rotator cuff calcium deposits. Several nonoperative interventions, extracorporeal shockwave therapy (ESWT) and ultrasonography-guided needling (UGN), and surgical techniques have been described to treat calcific tendonitis with satisfactory outcomes. Clinical guidelines are lacking for surgical excision in cases refractory to nonoperative treatment. Several arthroscopic and open operative techniques have been described to treat calcific tendonitis with satisfactory clinical outcomes. The purpose of this systematic review of randomized controlled trials is to compare outcomes and complications of nonoperative vs. operative management of chronic calcific tendinitis of the rotator cuff, to provide evidence-based treatment guidelines for practitioners. Methods EMBASE, PubMed, and OVID [MEDLINE] were searched from database inception until February 20, 2022, for randomized controlled trials reporting outcomes related to operative or nonoperative management for calcific tendonitis of the shoulder. Clinical outcomes including pain on visual analog scale (VAS), Constant-Murley Shoulder Outcome Score (CMS), and resolution of calcific deposits were evaluated. Continuous data at last follow-up was pooled into mean differences using a random effects model for meta-analysis. Results A total of 27 studies (2212 nonoperative patients and 140 operative patients) met the final inclusion criteria. Pooled mean difference in VAS for ESWT was –3.83 (95% confidence interval [CI] −5.38, −2.27); P < .001), compared to −4.83 (95% CI −5.44, −4.22; P < .001) for UGN, and −4.65 (95% CI −5.47, −3.82; P < .001) for the operative interventions. Pooled mean difference in CMS score after ESWT was 18.30 (95% CI 10.95, 25.66; P < .001) compared to 22.01 (95% CI 8.17, 35.84; P = .002) for UGN, and 38.35 (95% CI 31.68, 45.02; P < .001) for the operative interventions. Eighty-five percent of patients receiving operative and 67% of patients receiving UGN management had complete radiographic resolution of calcific deposit. Conclusions Surgical treatment of chronic calcific tendonitis of the rotator cuff results in larger improvement in functional outcome scores and comparable pain reduction to nonoperative interventions, particularly UGN. Both operative and nonoperative treatment modalities are likely to have clinically significant improvements in function and pain, and thus it is reasonable to trial UGN and ESWT as first-line treatment. Cost-effectiveness analyses will be needed to support one treatment over the other. High-quality randomized controlled trials directly comparing nonoperative interventions to operative interventions in patients prior to failing conservative treatment are needed to establish high-quality evidence-based guidelines. Calcific tendinitis is a relatively common shoulder disorder, with 7%-17% of individuals with shoulder pain having rotator cuff calcium deposits. Several nonoperative interventions, extracorporeal shockwave therapy (ESWT) and ultrasonography-guided needling (UGN), and surgical techniques have been described to treat calcific tendonitis with satisfactory outcomes. Clinical guidelines are lacking for surgical excision in cases refractory to nonoperative treatment. Several arthroscopic and open operative techniques have been described to treat calcific tendonitis with satisfactory clinical outcomes. The purpose of this systematic review of randomized controlled trials is to compare outcomes and complications of nonoperative vs. operative management of chronic calcific tendinitis of the rotator cuff, to provide evidence-based treatment guidelines for practitioners. EMBASE, PubMed, and OVID [MEDLINE] were searched from database inception until February 20, 2022, for randomized controlled trials reporting outcomes related to operative or nonoperative management for calcific tendonitis of the shoulder. Clinical outcomes including pain on visual analog scale (VAS), Constant-Murley Shoulder Outcome Score (CMS), and resolution of calcific deposits were evaluated. Continuous data at last follow-up was pooled into mean differences using a random effects model for meta-analysis. A total of 27 studies (2212 nonoperative patients and 140 operative patients) met the final inclusion criteria. Pooled mean difference in VAS for ESWT was –3.83 (95% confidence interval [CI] −5.38, −2.27); P < .001), compared to −4.83 (95% CI −5.44, −4.22; P < .001) for UGN, and −4.65 (95% CI −5.47, −3.82; P < .001) for the operative interventions. Pooled mean difference in CMS score after ESWT was 18.30 (95% CI 10.95, 25.66; P < .001) compared to 22.01 (95% CI 8.17, 35.84; P = .002) for UGN, and 38.35 (95% CI 31.68, 45.02; P < .001) for the operative interventions. Eighty-five percent of patients receiving operative and 67% of patients receiving UGN management had complete radiographic resolution of calcific deposit. Surgical treatment of chronic calcific tendonitis of the rotator cuff results in larger improvement in functional outcome scores and comparable pain reduction to nonoperative interventions, particularly UGN. Both operative and nonoperative treatment modalities are likely to have clinically significant improvements in function and pain, and thus it is reasonable to trial UGN and ESWT as first-line treatment. Cost-effectiveness analyses will be needed to support one treatment over the other. High-quality randomized controlled trials directly comparing nonoperative interventions to operative interventions in patients prior to failing conservative treatment are needed to establish high-quality evidence-based guidelines." @default.
- W4366245622 created "2023-04-20" @default.
- W4366245622 creator A5014735322 @default.
- W4366245622 creator A5019553083 @default.
- W4366245622 creator A5044905967 @default.
- W4366245622 creator A5066100967 @default.
- W4366245622 creator A5073543995 @default.
- W4366245622 creator A5078262796 @default.
- W4366245622 creator A5078696104 @default.
- W4366245622 creator A5081692078 @default.
- W4366245622 date "2023-08-01" @default.
- W4366245622 modified "2023-10-12" @default.
- W4366245622 title "Chronic calcific tendonitis of the rotator cuff: a systematic review and meta-analysis of randomized controlled trials comparing operative and nonoperative interventions" @default.
- W4366245622 cites W1863681930 @default.
- W4366245622 cites W1956541009 @default.
- W4366245622 cites W1970498123 @default.
- W4366245622 cites W1978314181 @default.
- W4366245622 cites W1986950374 @default.
- W4366245622 cites W1989711855 @default.
- W4366245622 cites W1995028072 @default.
- W4366245622 cites W1997318688 @default.
- W4366245622 cites W2010658210 @default.
- W4366245622 cites W2015101533 @default.
- W4366245622 cites W2020793500 @default.
- W4366245622 cites W2033463698 @default.
- W4366245622 cites W2034822988 @default.
- W4366245622 cites W2035238210 @default.
- W4366245622 cites W2038026801 @default.
- W4366245622 cites W2044635672 @default.
- W4366245622 cites W2051880848 @default.
- W4366245622 cites W2059492895 @default.
- W4366245622 cites W2061702120 @default.
- W4366245622 cites W2078149346 @default.
- W4366245622 cites W2080293498 @default.
- W4366245622 cites W2087229426 @default.
- W4366245622 cites W2088516062 @default.
- W4366245622 cites W2102245134 @default.
- W4366245622 cites W2106366405 @default.
- W4366245622 cites W2113224506 @default.
- W4366245622 cites W2113814779 @default.
- W4366245622 cites W2122277587 @default.
- W4366245622 cites W2125435699 @default.
- W4366245622 cites W2131880585 @default.
- W4366245622 cites W2134454918 @default.
- W4366245622 cites W2143326968 @default.
- W4366245622 cites W2143358865 @default.
- W4366245622 cites W2146468988 @default.
- W4366245622 cites W2147075964 @default.
- W4366245622 cites W2163766585 @default.
- W4366245622 cites W2188172648 @default.
- W4366245622 cites W2263920439 @default.
- W4366245622 cites W2317941379 @default.
- W4366245622 cites W2552816509 @default.
- W4366245622 cites W2576440140 @default.
- W4366245622 cites W2626388251 @default.
- W4366245622 cites W2756214149 @default.
- W4366245622 cites W2795813741 @default.
- W4366245622 cites W2911242456 @default.
- W4366245622 cites W3008103555 @default.
- W4366245622 cites W3008991211 @default.
- W4366245622 cites W3098621370 @default.
- W4366245622 cites W3138702419 @default.
- W4366245622 cites W3145345570 @default.
- W4366245622 cites W3196736840 @default.
- W4366245622 cites W3198929492 @default.
- W4366245622 doi "https://doi.org/10.1016/j.jse.2023.03.017" @default.
- W4366245622 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37080421" @default.
- W4366245622 hasPublicationYear "2023" @default.
- W4366245622 type Work @default.
- W4366245622 citedByCount "1" @default.
- W4366245622 countsByYear W43662456222023 @default.
- W4366245622 crossrefType "journal-article" @default.
- W4366245622 hasAuthorship W4366245622A5014735322 @default.
- W4366245622 hasAuthorship W4366245622A5019553083 @default.
- W4366245622 hasAuthorship W4366245622A5044905967 @default.
- W4366245622 hasAuthorship W4366245622A5066100967 @default.
- W4366245622 hasAuthorship W4366245622A5073543995 @default.
- W4366245622 hasAuthorship W4366245622A5078262796 @default.
- W4366245622 hasAuthorship W4366245622A5078696104 @default.
- W4366245622 hasAuthorship W4366245622A5081692078 @default.
- W4366245622 hasConcept C108305453 @default.
- W4366245622 hasConcept C126322002 @default.
- W4366245622 hasConcept C141071460 @default.
- W4366245622 hasConcept C14184104 @default.
- W4366245622 hasConcept C142724271 @default.
- W4366245622 hasConcept C168563851 @default.
- W4366245622 hasConcept C1862650 @default.
- W4366245622 hasConcept C204787440 @default.
- W4366245622 hasConcept C27081682 @default.
- W4366245622 hasConcept C2776030733 @default.
- W4366245622 hasConcept C2776511800 @default.
- W4366245622 hasConcept C2777572544 @default.
- W4366245622 hasConcept C2777974732 @default.
- W4366245622 hasConcept C2780105995 @default.
- W4366245622 hasConcept C2909768578 @default.
- W4366245622 hasConcept C44249647 @default.
- W4366245622 hasConcept C56837625 @default.
- W4366245622 hasConcept C71924100 @default.