Calcifying Tendinopathy of the Rotator Cuff: Barbotage vs. Shock Waves: Controlled Clinical Trial Protocol (BOTCH)

Background: Shoulder pain is a very common health issue among adults, being 8% due to calcifying tendinopathies (CT) of the shoulder. The evolutionary process of this lesion can be classified according to Bianchi Martinoli, depending on the ultrasound appearance. In 50% of cases, with first-line treatments, they resolve spontaneously. However, in the remaining 50%, they become chronic, requiring other lines of treatment, such as shock waves (ESWT) or ultrasound-guided barbotage (US-PICT). Objectives: The objective focuses on comparing the improvement in pain using the visual analgesic scale (VAS) and shoulder joint balance (ROM) in patients with CT based on the treatment received, stratifying according to the characteristics of the injury, with the aim of protocolizing said treatment. Methods: Randomized analytical controlled clinical trial in blocks with two arms according to the Bianchi Martinolli classification (I or II/III) in 56 patients affected by chronic pain by CT. The decision to treat will be made randomly 1:1, based on the treatment assigned to the previous patient. Results will be evaluated in three moments (1, 3, and 6 months). The following variables will be collected: VAS, Lattinen test, ROM (flexion, abduction, external and internal rotation), patient global improvement impression scale (PGI-I), global improvement impression scale (CGI-C). Discussion: The use of ESWT or US-PICT as treatments is a widely used practice in the daily life of this pathology. However, despite knowing that both treatments are useful in chronic CT, there are no known data or protocols by which one therapy is chosen over another, much less the influence that the evolutionary stage can have of the injury in the results obtained.