Efficacy of ultrasound-guided percutaneous lavage for rotator cuff calcific tendinopathy: A systematic review and meta-analysis

Tao Zhang, Yanji Duan, Jing Chen, Xiao Chen, Tao Zhang, Yanji Duan, Jing Chen, Xiao Chen

Abstract

Background: Rotator cuff calcific tendinopathy (RCCT) is frequently diagnosed in patients with shoulder pain, but there is no consensus on its treatment such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, subacromial corticosteroid injection (SAI), extracorporeal shock wave therapy (ESWT), and ultrasound-guided percutaneous lavage (UGPL). The aim of the study was to compare the effectiveness of UGPL with other techniques in the treatment of RCCT.

Methods: Literature searches of PubMed, EMBASE, OVID, Cochrane Library, Web of Science, Chinese Biomedical Literature, Wanfang, Weipu Journal, and CNKI databases were performed up to August 2018. Only randomized controlled trials (RCTs) comparing UGPL vs other methods for RCCT were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards.

Results: Eight RCTs were included with 617 cases in all. The result of meta-analysis showed that: there were significant differences between the UGPL and ESWT group in 12-month follow-up VAS, constant shoulder score (CSS), the average particle size of the calcium deposition, and the calcification disappearance rate. However, there was no significant difference in complication between 2 groups.

Conclusion: The present meta-analysis indicates that UGPL has certain clinical effect for calcifying tendinitis of rotator cuff. Compared with ESWT, UGPL may be superior in clinical pain relief and calcification clearance. However, owing to the limited quality and quantity of the included studies, additional high-quality RCTs are needed to confirm these findings.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The flow chart of literature selection.
Figure 2
Figure 2
Risk of bias assessment summary of this meta-analysis.
Figure 3
Figure 3
Forest plot of visual analog score between 2 groups at 3, 6, and 12 months.
Figure 4
Figure 4
Forest plot of the mean size of the deposits between 2 groups.
Figure 5
Figure 5
Forest plot of the calcification disappearance rate between 2 groups.
Figure 6
Figure 6
Forest plot of constant shoulder score between 2 groups.
Figure 7
Figure 7
Forest plot of need for surgery between 2 groups.
Figure 8
Figure 8
Forest plot of complication between 2 groups.
Figure 9
Figure 9
Funnel plots for publication bias test for VAS.
Figure 10
Figure 10
Funnel plots for publication bias test for the calcification disappearance rate.
Figure 11
Figure 11
Funnel plots for publication bias test for CSS.
Figure 12
Figure 12
Sensitivity analysis: for VAS.
Figure 13
Figure 13
Sensitivity analysis: for the calcification disappearance rate.
Figure 14
Figure 14
Sensitivity analysis: for CSS.

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