Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder

A prospective quasirandomized study was performed to compare the effects of surgical extirpation (Group I, 29 patients) with the outcome after high-en ergy extracorporeal shock wave therapy (Group II, 50 patients; 3000 impulse s of an energy flux density of 0.6 mJ/mm(2)) in patients with a chronic cal cifying tendinitis in the supraspinatus tendon. Symptoms and demographic da ta of the two groups were comparable. According to the University of Califo rnia Los Angeles Rating System, the mean score in Group I was 30 points wit h 75% good or excellent results after 12 months, and 32 points with 90% goo d or excellent results after 24 months. Radiologically, there was no calcif ic deposit in 85% of the patients after 1 year. In Group II, the mean score was 28 points with 60% good or excellent results after 12 months, and 29 p oints with 64% good or excellent results after 2 years. Radiologically, com plete elimination of the deposit was observed in 47% of the patients after I year. Clinically, according to the University of California Los Angeles s core, there was no significant difference between both groups at 1 year. At 2 years, there was a significantly better result in Group II. Both groups then were subdivided into patients who had a homogenous deposit as seen on radiographs and patients who had an inhomogenous deposit before treatment. Surgery was superior compared with high-energy shock wave therapy for patie nts with homogenous deposits. For patients with inhomogenous deposits, high -energy extracorporeal shock wave therapy was equivalent to surgery and sho uld be given priority because of its noninvasiveness.