Article

OBJECTIVE: To investigate the effectiveness of various nonoperative treatments
for chronic calcific tendinitis of the shoulder, a systematic review and network
meta-analysis of randomized trials was performed to evaluate changes in pain
reduction, functional improvements in patients with calcific tendinitis, and the
ratio of complete resolution of calcific deposition. DATA SOURCES: Studies were
comprehensively searched, without language restrictions, on PubMed, Embase,
Cochrane Controlled Trials Register, the Cochrane, and other databases. The
reference lists of articles and reviews were cross-checked for possible studies.
STUDY SELECTION: Randomized controlled trials from before August 2016 were
included. Study selection was conducted by 2 reviewers independently. DATA
EXTRACTION: The quality of studies was assessed and data extracted by 2
independent reviewers. Disagreements were settled by consulting a third reviewer
to reach a consensus. DATA SYNTHESIS: Fourteen studies with 1105 participants
were included in the network meta-analysis that used a random-effect model to
investigate the mean difference of pooled effect sizes of the visual analog
scale, Constant-Murley score, and the ratio of complete resolution of calcific
deposition on native radiographs. CONCLUSIONS: The present network meta-analysis
demonstrates that ultrasound-guided needling (UGN), radial extracorporeal
shockwave therapy (RSW), and high-energy focused extracorporeal shockwave therapy
(H-FSW) alleviate pain and achieve complete resolution of calcium deposition.
Compared with low-energy focused extracorporeal shockwave therapy, transcutaneous
electrical nerve stimulation, and ultrasound therapy, H-FSW is the best therapy
for providing functional recovery. Physicians should consider UGN, RSW, and H-FSW
as alternative effective therapies for chronic calcific tendinitis of the
shoulder when initial conservative treatment fails.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS