Extracorporeal Shock Wave Combined With Ultrasound Guided Injection For The Treatment Of Supraspinatus Calcified Tendinitis

Objective: The clinical effect of extracorporeal shock wave combine with ultrasound guided steroid injection was compared with that under the guidance of single ultrasound.To verify the therapeutic effect of steroid hormone injection under the guidance of extracorporeal shock wave and ultrasound,and to provide a simple,effective and easy to operate treatment method for calcified tendinitis of supraspinatus muscle.Methods:40 patients with calcified tendinitis of supraspinatus muscle admitted to the hand surgery(Shoulder and elbow surgery)department of Wuhan fourth hospital from September2018 to March 2019 were included in this study.They were randomly divided into experimental group and control group,in which 20 cases were treated by extracorporeal shock wave combine with ultrasound guided steroid injection in experimental group,and 20 cases were treated by steroid injection under the guidance of ultrasound in control group.The visual analogue pain score(VAS),constant Murley shoulder function score(c-ms)and the maximum transverse diameter of calcifications were recorded before treatment,2 weeks,4weeks,1 month,3 months and 6 months after treatment,and the reduction rate of calcifications in 4 weeks,3 months and 6 months after treatment was compared with that before treatment.The data of the two groups were analyzed statistically.Results:1 ? There was no significant difference between the two groups(P > 0.05).All patients were followed up for 6-13 months(average 8.4 months).2?The visual analogue pain score(VAS)was used as the curative effect index to compare:the VAS scores of the two groups after 2 weeks,4 weeks,3 months and 6 months were significantly lower than those before treatment(P < 0.05).There was no significant difference between the two groups after 2 weeks and 4 weeks of treatment(P > 0.05).The VAS scores of the experimental group after 3 months and 6 months of treatment were lower than those of the control group(P < 0.05).The middle and long term(> 4 weeks)experimental group had better analgesic effect.3?Constant Murley shoulder function score(c-ms)was used as the therapeutic index to compare: the C-M scores of the two groups were significantly higher than those of the two groups before treatment(P < 0.05),and there was no significant difference between the two groups after treatment(P > 0.05),the C-M scores of the experimental group were higher than those of the control group(P < 0.05).In the middle and long term(> 4 weeks),the function of shoulder joint in the experimental group was better recovered.4?There was no significant difference in the reduction rate of calcification under ultrasound 4 weeks after treatment(P > 0.05).The reduction rate of calcification in the experimental group was higher than that in the control group 3 and 6 months after treatment(P < 0.05).In the middle and long term(> 4 weeks),the absorption of calcification was more effectively promoted in the experimental group.Conclusions:Extracorporeal shock wave combine with ultrasound guided steroid injection has a good clinical effect in the treatment of calcified tendinitis of supraspinatus muscle.Compared with the single steroid injection,the two kinds of treatment can effectively relieve pain and recover some joint functions in the near future(< 4 weeks).There is no significant difference in the effect comparison.In the middle and long term(> 4 weeks),the injection of steroid hormone under the guidance of extracorporeal shock wave and ultrasound can reduce the pain,promote the absorption of calcification and restore the function of shoulder joint.