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Extracorporeal Shockwave Therapy in Calcific Tendinosis of
the Rotator Cuff:
Comparision of Radial and Focal Treatment
Edson Serrano, Karim Flores, Jean Carlos Criado
Institution: Neomedica Shockwave Unit; Lima, Peru
Device and producing company: ORTHOGOLD 100, MTS; BTL 5000, BTL 6000
Introduction: Calcific tendinosis of the shoulder is often associated with chronic pain
and impairment of function. Extracorporeal shockwave therapy (ESWT) is considered to
be a treatment option. We compared the effects of two different ESWT technologies:
focal and radial.
Methods: Forty eight shoulders were followed in 2 groups of twenty-four each. The
treatment was weekly consisted of 3 x 2000 focal electrohidraulic shockwave with an
energy flux density of 0.14-0.2 mJ/mm2 without anesthesia (group A) and 5 x 6000
impulses of radial impulses with progresive protocol (group B). The patients were
examined at a 4 weeks, 3 and 6 months after treatment. X-rays were performed at each
Results: In six months of folllowing after treatment the Constant Score improved from
52.5 to 78.4 in group A and from 54.2 to 72.6 in group B (p < 0.05). The values on the
visual analog scale which ranges from 0 (no pain) to 10 (maximal pain) improved from
7.7 to 3.1 (group A) and from 7.4 to 3.3 (group B) before and 6 months after treatment
respectively. X-rays showed a complete or subtotal calcific resorption in 56% in group A,
and 38% in group B of patients.
Discussion: This is a preliminary study indicates that three sessions of extracorporeal
electrohidraulic focal shockwave therapy with energy flux density of 0.14-0.2 mJ/mm2
may be as effective as five applications of a radial extracorporeal shockwave therapy
with progressive protocol for calcific tendinosis of rotator cuff. Focal technology shortens
the treatment time, but the radial treatment is more accessible to people.
Conclusion: Both technologies of ESWT (focal and radial) had successful and
comparable result in the treated patients with calcific tendinosis of rotator cuff of the
shoulder. No complications seen in six months of following.
Subjectively, 84% of group A and 76% of group B judged the treatment to be successful.
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