Yuming Yao, Guang Yang, Shide Jiang, Bingzhou Ji, Hongfu Jin, Peiyuan Tang, Hengzhen Li, Bangbao Lu, Yusheng Li
{"title":"肩袖钙化肌腱炎的治疗：随机对照试验的系统回顾和网络荟萃分析。","authors":"Yuming Yao, Guang Yang, Shide Jiang, Bingzhou Ji, Hongfu Jin, Peiyuan Tang, Hengzhen Li, Bangbao Lu, Yusheng Li","doi":"10.1530/EOR-2024-0078","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Various conservative and surgical treatments was clinically applied in rotator cuff calcific tendinitis (RCCT), the evaluation of distinction among all available intervention is still lacking. This study aims to systematically compare the efficacy and safety of these interventions and provide guidance for RCCT treatment.</p><p><strong>Methods: </strong>The study utilized four electronic databases for literature retrieval and is registered in PROSPERO. Network meta-analyses (NMA) were conducted for continuous outcomes such as functional improvement and pain relief. For the outcome of calcification deposit resolution, due to discrepancies in statistical methods and insufficient data for pooling, a systematic review was conducted. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias.</p><p><strong>Results: </strong>A total of 33 randomized-controlled trials (RCTs) covering 26 treatment methods were included. In nonsurgical treatments, comprehensive physical therapy (PT) methods (ranked 1st in Surface Under the Cumulative Ranking (SUCRA)) showed the best performance in terms of functional improvement, followed by high-energy extracorporeal shock wave therapy (ESWT-H) + PT, which ranked 2nd. For pain relief, radial shock wave therapy (RSWT) + PT (ranked 1st) was most effective. In surgical treatments, arthroscopic bursectomy debridement of rotator cuff (ABD) + arthroscopic subacromial decompression (ASD) showed similar effects to ABD alone for functional improvement (SMD: -0.01, 95% CI: -0.54 to 0.57) and pain relief (SMD: -0.02, 95% CI: -0.51 to 0.43), with no significant differences observed. For calcification resolution, ultrasound-guided needling (UGN) + subacromial corticosteroid injection (SAI) demonstrated promising therapeutic potential.</p><p><strong>Conclusion: </strong>Comprehensive PT demonstrates superior efficacy in improving functional outcomes, while RSWT + PT significantly alleviates pain. In terms of surgical interventions, ABD alone demonstrated similar clinical effects to ABD + ASD in both functional improvement and pain relief. However, there is currently no direct data to compare the effectiveness of operative versus nonoperative treatments for RCCT.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023476423.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 7","pages":"520-533"},"PeriodicalIF":4.0000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232402/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatments for rotator cuff calcific tendinitis: a systematic review and network meta-analysis of randomized-controlled trials.\",\"authors\":\"Yuming Yao, Guang Yang, Shide Jiang, Bingzhou Ji, Hongfu Jin, Peiyuan Tang, Hengzhen Li, Bangbao Lu, Yusheng Li\",\"doi\":\"10.1530/EOR-2024-0078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Various conservative and surgical treatments was clinically applied in rotator cuff calcific tendinitis (RCCT), the evaluation of distinction among all available intervention is still lacking. This study aims to systematically compare the efficacy and safety of these interventions and provide guidance for RCCT treatment.</p><p><strong>Methods: </strong>The study utilized four electronic databases for literature retrieval and is registered in PROSPERO. Network meta-analyses (NMA) were conducted for continuous outcomes such as functional improvement and pain relief. For the outcome of calcification deposit resolution, due to discrepancies in statistical methods and insufficient data for pooling, a systematic review was conducted. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias.</p><p><strong>Results: </strong>A total of 33 randomized-controlled trials (RCTs) covering 26 treatment methods were included. In nonsurgical treatments, comprehensive physical therapy (PT) methods (ranked 1st in Surface Under the Cumulative Ranking (SUCRA)) showed the best performance in terms of functional improvement, followed by high-energy extracorporeal shock wave therapy (ESWT-H) + PT, which ranked 2nd. For pain relief, radial shock wave therapy (RSWT) + PT (ranked 1st) was most effective. In surgical treatments, arthroscopic bursectomy debridement of rotator cuff (ABD) + arthroscopic subacromial decompression (ASD) showed similar effects to ABD alone for functional improvement (SMD: -0.01, 95% CI: -0.54 to 0.57) and pain relief (SMD: -0.02, 95% CI: -0.51 to 0.43), with no significant differences observed. For calcification resolution, ultrasound-guided needling (UGN) + subacromial corticosteroid injection (SAI) demonstrated promising therapeutic potential.</p><p><strong>Conclusion: </strong>Comprehensive PT demonstrates superior efficacy in improving functional outcomes, while RSWT + PT significantly alleviates pain. In terms of surgical interventions, ABD alone demonstrated similar clinical effects to ABD + ASD in both functional improvement and pain relief. However, there is currently no direct data to compare the effectiveness of operative versus nonoperative treatments for RCCT.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023476423.</p>\",\"PeriodicalId\":48598,\"journal\":{\"name\":\"Efort Open Reviews\",\"volume\":\"10 7\",\"pages\":\"520-533\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232402/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Efort Open Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1530/EOR-2024-0078\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Efort Open Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1530/EOR-2024-0078","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Treatments for rotator cuff calcific tendinitis: a systematic review and network meta-analysis of randomized-controlled trials.
Purpose: Various conservative and surgical treatments was clinically applied in rotator cuff calcific tendinitis (RCCT), the evaluation of distinction among all available intervention is still lacking. This study aims to systematically compare the efficacy and safety of these interventions and provide guidance for RCCT treatment.
Methods: The study utilized four electronic databases for literature retrieval and is registered in PROSPERO. Network meta-analyses (NMA) were conducted for continuous outcomes such as functional improvement and pain relief. For the outcome of calcification deposit resolution, due to discrepancies in statistical methods and insufficient data for pooling, a systematic review was conducted. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias.
Results: A total of 33 randomized-controlled trials (RCTs) covering 26 treatment methods were included. In nonsurgical treatments, comprehensive physical therapy (PT) methods (ranked 1st in Surface Under the Cumulative Ranking (SUCRA)) showed the best performance in terms of functional improvement, followed by high-energy extracorporeal shock wave therapy (ESWT-H) + PT, which ranked 2nd. For pain relief, radial shock wave therapy (RSWT) + PT (ranked 1st) was most effective. In surgical treatments, arthroscopic bursectomy debridement of rotator cuff (ABD) + arthroscopic subacromial decompression (ASD) showed similar effects to ABD alone for functional improvement (SMD: -0.01, 95% CI: -0.54 to 0.57) and pain relief (SMD: -0.02, 95% CI: -0.51 to 0.43), with no significant differences observed. For calcification resolution, ultrasound-guided needling (UGN) + subacromial corticosteroid injection (SAI) demonstrated promising therapeutic potential.
Conclusion: Comprehensive PT demonstrates superior efficacy in improving functional outcomes, while RSWT + PT significantly alleviates pain. In terms of surgical interventions, ABD alone demonstrated similar clinical effects to ABD + ASD in both functional improvement and pain relief. However, there is currently no direct data to compare the effectiveness of operative versus nonoperative treatments for RCCT.
期刊介绍：
EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity.
This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances.
One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress.
EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
