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Updated: Aug 6, 2026
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Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source
Published on: December 23, 2022
Comparable Midterm Outcomes for Ultrasound-Guided Needling Versus High-Energy Shockwave Therapy for Rotator Cuff
Dominic M van Noort1, Jan K G Louwerens1,2, Inger N Sierevelt1,3,4
1Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, Netherland.
Summary
Extracorporeal shockwave therapy (ESWT) and ultrasound-guided needling (UGN) demonstrate excellent midterm outcomes for rotator cuff calcific tendinitis (RCCT). Both treatments achieved significant clinical improvements, with no significant differences between them.
Area of Science:
- Orthopedics
- Musculoskeletal Medicine
- Radiology
Background:
- Rotator cuff calcific tendinitis (RCCT) is a common cause of shoulder pain.
- Conservative treatments often fail to resolve symptoms, necessitating further intervention.
- Midterm outcomes of advanced therapies require thorough evaluation.
Purpose of the Study:
- To compare the midterm clinical and radiographic outcomes of extracorporeal shockwave therapy (ESWT) and ultrasound-guided needling (UGN) for symptomatic RCCT.
- To assess the efficacy and recurrence rates of these treatments at a minimum 5-year follow-up.
Main Methods:
- A randomized controlled trial followed 82 patients with persistent RCCT (>5mm, Gärtner type I-II).
- Patients received either high-energy ESWT (4 sessions) or single ultrasound-guided needling (puncture and lavage).
- Outcomes measured at 5 years included Constant-Murley Score (CMS), DASH questionnaire, VAS pain, and radiographic assessment of calcifications.
Main Results:
- Sixty-seven patients (82%) completed the 5-year follow-up.
- Both ESWT and UGN groups showed excellent mean CMS (94.4 vs. 93.3, P=.67) with 94% achieving minimal clinically important difference.
- No recurrence of calcific deposits in treated tendons; 15% of UGN patients developed new deposits in other tendons.
Conclusions:
- ESWT and UGN provide excellent midterm clinical and radiographic outcomes for RCCT.
- Both treatments are effective, with no significant intergroup differences in key scores.
- High rates of additional treatments were noted, suggesting potential for underpowered analysis.
