Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials
Background Rotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy r...
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| Language: | English |
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open Sport & Exercise Medicine |
| Online Access: | https://bmjopensem.bmj.com/content/5/1/e000506.full |
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| author | Jean-Sébastien Roy Simon Lafrance Patrick Doiron-Cadrin Marie Saulnier Martin Lamontagne Nathalie J Bureau Joseph-Omer Dyer François Desmeules |
| author_facet | Jean-Sébastien Roy Simon Lafrance Patrick Doiron-Cadrin Marie Saulnier Martin Lamontagne Nathalie J Bureau Joseph-Omer Dyer François Desmeules |
| author_sort | Jean-Sébastien Roy |
| collection | DOAJ |
| description | Background Rotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy remains inconclusive. The aim of this systematic review and meta-analysis is to update the available evidence on the efficacy of ultrasound-guided lavage in adults with rotator cuff calcific tendinopathy.Methods A literature search was conducted up to April 2018 in four bibliographic databases to identify randomised control trials that compared ultrasound-guided lavage alone with other interventions to treat rotator cuff calcific tendinopathy. Randomised control trials were assessed with the Cochrane Risk of Bias Tool. Meta-analyses and/or qualitative synthesis of the evidence were performed.Results Three randomised control trials were included. Pooled results for pain (n=226) indicated that ultrasound-guided lavage may significantly decrease pain when compared with shockwave therapy, with a mean difference of −1.98 out of 10 points (95% CI −2.52 to −1.45) in the short term and of −1.84 (95% CI −2.63 to −1.04) in the long term. Based on one trial (n=25), ultrasound-guided lavage significantly improved function when compared with shockwave therapy (p<0.05). Based on another trial (n=48), the addition of ultrasound-guided lavage to a corticosteroid injection significantly improves function in the long term (p<0.05).Conclusion For individuals with rotator cuff calcific tendinopathy, low-quality evidence suggests that ultrasound-guided lavage is more effective than shockwave therapy or a corticosteroid injection alone. Future trials could modify the present conclusions.Trial registration number CRD42018095858. |
| format | Article |
| id | doaj-art-02ba50084cbc4bf9bfc87f8d99a2dbb2 |
| institution | OA Journals |
| issn | 2055-7647 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Sport & Exercise Medicine |
| spelling | doaj-art-02ba50084cbc4bf9bfc87f8d99a2dbb22025-08-20T01:54:25ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472019-10-015110.1136/bmjsem-2018-000506Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trialsJean-Sébastien Roy0Simon Lafrance1Patrick Doiron-Cadrin2Marie Saulnier3Martin Lamontagne4Nathalie J Bureau5Joseph-Omer Dyer6François Desmeules7Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada1 Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Canada1 Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Canada1 Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Canada2 Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada3 University of Montreal Hospital Center Research Center (CRCHUM), Montreal, Canada5 School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, CanadaSchool of Rehabilitation, Medicine Faculty, University of Montreal, Montreal, Quebec, CanadaBackground Rotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy remains inconclusive. The aim of this systematic review and meta-analysis is to update the available evidence on the efficacy of ultrasound-guided lavage in adults with rotator cuff calcific tendinopathy.Methods A literature search was conducted up to April 2018 in four bibliographic databases to identify randomised control trials that compared ultrasound-guided lavage alone with other interventions to treat rotator cuff calcific tendinopathy. Randomised control trials were assessed with the Cochrane Risk of Bias Tool. Meta-analyses and/or qualitative synthesis of the evidence were performed.Results Three randomised control trials were included. Pooled results for pain (n=226) indicated that ultrasound-guided lavage may significantly decrease pain when compared with shockwave therapy, with a mean difference of −1.98 out of 10 points (95% CI −2.52 to −1.45) in the short term and of −1.84 (95% CI −2.63 to −1.04) in the long term. Based on one trial (n=25), ultrasound-guided lavage significantly improved function when compared with shockwave therapy (p<0.05). Based on another trial (n=48), the addition of ultrasound-guided lavage to a corticosteroid injection significantly improves function in the long term (p<0.05).Conclusion For individuals with rotator cuff calcific tendinopathy, low-quality evidence suggests that ultrasound-guided lavage is more effective than shockwave therapy or a corticosteroid injection alone. Future trials could modify the present conclusions.Trial registration number CRD42018095858.https://bmjopensem.bmj.com/content/5/1/e000506.full |
| spellingShingle | Jean-Sébastien Roy Simon Lafrance Patrick Doiron-Cadrin Marie Saulnier Martin Lamontagne Nathalie J Bureau Joseph-Omer Dyer François Desmeules Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials BMJ Open Sport & Exercise Medicine |
| title | Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials |
| title_full | Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials |
| title_fullStr | Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials |
| title_full_unstemmed | Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials |
| title_short | Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials |
| title_sort | is ultrasound guided lavage an effective intervention for rotator cuff calcific tendinopathy a systematic review with a meta analysis of randomised controlled trials |
| url | https://bmjopensem.bmj.com/content/5/1/e000506.full |
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