Calcific Tendinitis
Conditions
Brief summary
Calcific tendinitis is a common and challenging problem in the orthopedic surgeon's office. The chronic and variable course of the condition can lead to dissatisfaction with conservative management. Current standard of care at the Thunder Bay Regional Health Sciences Centre is referral for treatment by either needle decompression therapy by a radiologist or shockwave therapy by a physiotherapist. The purpose of this study is to compare the efficacies of these treatment options.
Detailed description
Calcific tendinitis is a common and challenging problem in the orthopedic surgeon's office. The chronic and variable course of the condition can lead to dissatisfaction with conservative management. Current guidelines recommend conservative management initially and failing this, a variety of minimally invasive options exist. These include subacromial steroid injection (SSI), needle decompression (ND), and Shock wave therapy (SWT). Few trials of these methods exist, but generally a benefit is seen with all minimally invasive methods. Most promising results have occurred with needle decompression and shockwave therapy. To date, no direct trials comparing SWT and ND have been published. The purpose of this trial is to preliminarily establish the comparative efficacies of NDSSI and SWT using a number of outcome measures. Secondarily, the investigators aim to determine prognostic factors for success of minimally invasive therapies. The results of this study will serve as a foundation for more rigorous trials in this area.
Interventions
PROCEDURENeedle decompression
Direct manipulation of calcium deposits in the shoulder with a needle to fragment the deposit performed by a radiologist.
PROCEDUREShockwave therapy
A physiotherapist performs the shockwave therapy procedure. Treatment is completed in 4 weekly sessions. Treatment involves applying soundwaves directly to the affected shoulder area using an ultrasound device.
DRUGDepo medrol
Subacromial steroid injection (40 mg depo medrol) is given to the patient to limit irritation following needle decompression.
DEVICEUltrasound device
Ultrasound device is applied directly to the shoulder at 0.2 mJ/mm2.
Sponsors
Lakehead University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* New diagnosis of symptomatic calcific tendinitis of the shoulder * Seeking treatment for diagnosis * ≥ 18 years of age
Exclusion criteria
* Pre-existing diagnosis of rotator cuff tear or arthropathy * Previous minimally invasive or surgical therapy * Systemic Inflammatory disease * Blood dyscrasia * Peripheral neuropathy * Active Workplace Safety & Insurance Board (WSIB) claim for shoulder injury
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of Range of Motion | Baseline, 3 months, 1 year | The change in a Participant's Range of Motion as measured by a goniometer (Passive Range of Motion \[PROM\] and Assistive Range of Motion \[AROM\]) from baseline to 3 months and 1 year. |
| Change of Western Ontario Rotator Cuff (WORC) score | Baseline, 3 months, 1 year | Change in a participant's WORC scores from baseline to 3 months and 1 year. WORC is a condition-specific outcome tool for people with rotator cuff disorder. A total score for each domain is calculated (Physical Symptoms/600; Sports and Recreation/400; Work/400 and Lifestyle/400;Emotions/400) and the total score for the domains is summed for an aggregate score out of 2100. |
| Change of Gartland Classification of X-ray | Baseline, 3 months, 1 year | The change in radiographic resolution as measured by the Gartland Classification scale (1-4) from baseline to 3 months and 1 year. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The change in overall health as measured by the SF-8 | Baseline, 3 months, 1 year | The change in SF-8 from baseline to 3 months and 1 year will be measured. SF-8 is a comprehensive health survey which calculates a score for health in 8 dimensions and as a summed result. |
Countries
Canada
Contacts
Primary ContactJubin Payandeh, MD
Backup ContactAaron Burkhart, MD
Outcome results
None listed