Predictors of functional recovery in patients with rotator cuff calcific tendinopathy undergoing US-guided percutaneous lithoclasy: A retrospective study

Abstract

Background and aim: US-guided percutaneous irrigation (US-PICT) is a treatment option for rotator cuff calcific tendinopathy (RCCT). This secondary analysis of a prospective study was aimed to identify short-, medium, and long-term predictors of response to US-PICT. Methods: Subjects with symptomatic RCCT and calcium deposit >5 mm undergoing US-PICT were included. Changes in outcome measures at different time points were analyzed using Friedman ANOVA. Univariate and multivariate analyses evaluated predictors (age, gender, technique –one/two needle–, intra-procedural calcific outflow, calcification size and grade, post-procedure rehabilitation) of clinical outcomes (change from baseline assessment in pain at rest and on movement, Constant-Murley Score, Oxford Shoulder Score) at one, three, six and twelve months. Results: Overall, 162 patients (169 shoulders) were included. Significant improvements in pain and function were found one month after UGPL (p <0.001) and retained at 12 months. Worse baseline clinical scores were the strongest predictors of improvements, with R2 ranging 0.469-0.992 at 12-months assessment. Calcification size and Farin grade explained a minimal additional variance at one or more follow-ups. Conclusions: US-PICT is safe and effective in both the short term and the long term, and baseline severity is the main predictor of improvement in pain and function after the procedure.