Questioning the therapeutic value of corticosteroid bursal injection after ultrasound-guided irrigation and lavage for the treatment of shoulder calcific tendinosis

Michael-Alexander Malahias; Efstathios Chronopoulos; Vasileios Raoulis; Nikolaos Vergados; Maria-Kyriaki Kaseta; Vasileios S Nikolaou

doi:10.1016/j.jor.2019.10.009

Questioning the therapeutic value of corticosteroid bursal injection after ultrasound-guided irrigation and lavage for the treatment of shoulder calcific tendinosis

J Orthop. 2019 Oct 31:18:16-22. doi: 10.1016/j.jor.2019.10.009. eCollection 2020 Mar-Apr.

Authors

Michael-Alexander Malahias¹, Efstathios Chronopoulos¹, Vasileios Raoulis², Nikolaos Vergados³, Maria-Kyriaki Kaseta¹, Vasileios S Nikolaou¹

Affiliations

¹ 2nd Orthopaedic Department. National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
² Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
³ "401" Military General Hospital, Athens, Greece.

Abstract

Objectives: The therapeutic value of corticosteroid bursal injection after ultrasound-guided irrigation and lavage for the treatment of shoulder calcific tendinosis has not been established yet in the long term.

Methods: 41 patients suffering from chronic symptomatic rotator cuff calcific tendinopathy were recruited for this study. Group A (20 patients) received a double needle ultrasound-guided irrigation and lavage of the calcification with xylocaine injection, while group B (21 patients) underwent a double needle ultrasound-guided irrigation and lavage of the calcification with a xylocaine and betamethazone bursal injection.

Results: After twelve months, we documented full -or almost full- decline (VAS: 0-20/100) of the symptoms in 70% of the group A patients and in 61.9% of the group B patients. There was no statistical difference (chi square, p < 0.05) in group success ratio. We also did not find any statistical difference as for the mean Q-DASH difference between the two groups (t-test).

Conclusions: It was proven that the additional use of corticosteroid bursal injection did not provide with any additional short- to mid-term therapeutic benefit those patients with shoulder calcific tendinopathy who were treated with ultrasound-guided aspiration.

Keywords: Calcific aspiration; Corticosteroid shoulder injection; Rotator cuff tendinopathy; Shoulder calcific; Ultrasound guided irrigation and lavage.