Clinical outcomes of ultrasound-guided aspiration and lavage in calcific tendinosis of the shoulder

Julie T. Lin, MD
Hospital for Special Surgery


Carolyn M. Sofka, MD

Associate Attending Radiologist, Hospital for Special Surgery
Associate Professor of Radiology, Weill Cornell Medical College

Gregory E. Lutz, MD

Physiatrist-in-Chief Emeritus, Hospital for Special Surgery
Associate Attending Physiatrist, Hospital for Special Surgery
Associate Professor of Clinical Rehabilitation Medicine, New York-Presbyterian Hospital

Ana Bracilovic, MD; Grant Cooper, MD; Physiatry Department, Hospital for Special Surgery Department of Rehabilitation Medicine, Weill Medical College of Cornell University

Abstract
Objective:
To determine the effectiveness of ultrasound-guided aspiration and lavage in the treatment of patients with calcific tendinosis of the shoulder.

Methods and Materials: Retrospective chart review resulted in forty-four patients who were identified as having received ultrasound-guided aspiration of calcific tendinosis of the shoulder between 2000 and 2003.  Of these, 36 patients were interviewed by telephone for pre- and post-treatment assessment of pain, shoulder function, prior shoulder surgery, injury and prescribed treatment modalities with a follow-up time of 8 months to 3.1 years (mean = 22.5 months).  L'Insalata score, numeric rating scale, patient satisfaction score served as outcome measures.

Results: Our criteria for a successful outcome included (1) 12-point or greater improvement in the L’Insalata shoulder rating questionnaire, (2) 2-point or greater improvement in the numeric rating scale (NRS), (3) patient satisfaction rating of “good,” “very good” or “excellent,” (4) patient willingness to undergo the procedure again if they experienced recurrent symptoms and (5) 1 month or less of analgesic medication use following the aspiration procedure.  We determined that ultrasound-guided aspiration of calcific tendonosis of the shoulder resulted in a successful outcome for 75% (27/36) of patients with a mean 20.2 point improvement in the L’Insalata shoulder rating questionnaire score and a mean 6.4 point improvement in the numeric rating scale (p < 0.01).

Conclusion: This retrospective study suggests that ultrasound-guided aspiration and lavage of calcific shoulder deposits appears to be an efficacious therapeutic modality for treatment of calcific tendinosis.  Further studies involving prospective randomized controlled trials would be helpful to further assess the long-term efficacy of this procedure as a minimally invasive treatment for calcific tendinosis of the shoulder.

This article appears in HSS Journal: Volume 3, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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