US-guided percutaneous irrigation of extra-shoulder calcific tendinitis

Objectives: To investigate the efficacy and safety of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) applied out of the shoulder, comparing its effectiveness to US-PICT of the rotator cuff. Methods: Patients subjected to US-PICT for extra-shoulder calcific tendinitis (Case Group) were compared to those subjected to US-PICT of the rotator cuff (Control Group). We had pre-procedure Visual Analogue Scale (VAS) pain score, 1- and 3-month VAS of patients of the Case Group, pre-procedure and 3-month VAS of patients of the Control Group. Results: The Case Group consisted of 41 patients (27 women; mean age: 45 +/- 9years): 26 gluteus medius, 5 patellar tendon, 3 rectus femoris, 2 gluteus maximus, 2 common extensor tendon, 1 extensor carpi radialis longus, 1 pes anserinus, and 1 peroneus longus. The Control Group included 41 patients (27 women; mean age: 47 +/- 11 years). The mean pre-procedure VAS of the Case Group was 8.8 +/- 0.7 with a significant (P<.001) drop at 1 month (4.5 +/- 0.6) and 3 months (3.6 +/- 0.6). The mean pre-procedure VAS of the Control Group was 8 +/- 1.4 and dropped to 3.1 +/- 1.6 after 3 months (P<.001). Post-treatment VAS at 3 months was not significantly different between two Groups (P = 0.134). Similarly, the decrease of VAS from baseline to 3 months was not significantly different between the two Groups (P = 0.264). Conclusions: US-PICT is a safe and effective procedure that can be used out of the shoulder. Advances in knowledge: This study demonstrated the safety and effectiveness of US-PICT as a valuable therapeutic option for extra-shoulder calcific tendinitis, with similar clinical outcome to the same procedure performed in the rotator cuff. The technique must be adapted in some deeply located calcifications by means of the use of different needles and by thoroughly planning the access point for the procedure.