Abstract
Background
To determine if double needle ultrasound-guided hydrodissolution and aspiration of intratendinous calcification is more effective treatment than blind subacromial corticosteroid injection.
Methods
A prospective randomised comparative clinical study of 32 patients suffering from chronic symptomatic calcific tendinosis of the supraspinatous tendon. Group A (16 patients) received a double needle ultrasound-guided aspiration of the calcification, while group B (16 patients) underwent a blind subacromial betamethazone injection. As far as group A, we attached a syringe in the first needle, including 10cc. of normal saline (N/S), that we injected targeting the calcium deposit. Then we tried to achieve consecutive aspirations through the second needle.
Results
Patients were evaluated by an independent researcher who measured the visual analogue scale (VAS) 100/100 and the range of motion (ROM): a. before, b. 10 days and c. 6 months after the injection. In most cases of group A, we observed a noticeable amount of aspirated milky or mixed white-red coloured fluid at the bottom of the syringe. This fact proves right and effective guidance of the ultrasound. After six months, we documented full –or almost full- decline (VAS: 0–20/100) of the symptoms in 62.75 % of the group A patients and in 43.75% of the group B patients. The 6 month's mean VAS fall rate was 45/100 in group A and 33/100 in group B. Corticosteroid injected patients proved to have better outcome inside the first 10 days. The mean abduction of the humerus in the 6 month's follow-up was 110 degrees (from 77.5 degrees prior to aspiration) for the group A and 85 degrees for group B (from 72.5 degrees -prior).
Conclusion
Double needle dissolution -and aspiration- with N/S represents better long-term results (regarding ROM and pain release) than blind corticosteroid injection in the treatment of chronic symptomatic calcific tendinosis.
Level I
