Is extracorporeal shockwave therapy for calcifying tendinitis of the rotator cuff associated with a significant improvement in the constant-murley score? A systematic review
Saithna A., Jenkinson E., Boer R., Costa ML., Drew S.
Calcifying tendinitis of the rotator cuff is a common enthesopathy characterized by calcium pyrophosphate crystal deposition. Patients present with impingement type symptoms that include restricted range of movement and pain, particularly on abduction or overhead activities. The first line of treatment typically is conservative and includes physiotherapy, nonsteroidal antiinflammatory medications and corticosteroid injection. Failure of conservative management is an indication for operative intervention. Extracorporeal shock wave therapy (ESWT) has been suggested as an alternative to surgery. The primary objective of this systematic review was to evaluate whether there was a significant improvement in the Constant-Murley score after treatment of calcifying tendinitis of the rotator cuff when treated with ESWT compared with a placebo at 6 months. A systematic review with critical appraisal of relevant randomized controlled trials published between January 2003 and May 2008 was performed. Three studies met the eligibility criteria and were critically appraised. All studies demonstrated a statistically significant improvement in the mean Constant-Murley score after ESWT when compared with placebo at 6 months (mean improvement in Constant-Murley score; Gerdesmeyer 24.4, Cosentino 32 and Hsu 30.7). Despite variability in the quality of included studies and the treatment regimen and ESWT device used, all authors demonstrated a similar improvement in the Constant-Murley score at 6 months suggesting that ESWT is a useful nonoperative treatment modality for calcifying tendinitis of the rotator cuff. Copyright © Lippincott Williams & Wilkins.