Shoulder function after extracorporal shock wave therapy for calcific tendinitis

We report a controlled, prospective study that explored the effect of extracorporal shock waves of low- versus high-energy density in patients with chronic shoulder pain and calcific tendinitis. We assigned at random 100 patients who had had calcific tendinitis for more than 12 months to 2 groups to receive shock wave therapy either of a low- or high-energy density. Group 1 received 1500 impulses of 0.06 mJ/mm2, whereas group 2 received 1500 impulses of 0.28 mJ/mm2. Unlike group 1, in which the shock wave application could be performed without local anesthesia, all patients in group 2 required brachial plexus anesthesia. The patients were reviewed at 6 and 24 weeks. Partial or complete disintegration of the calcareous deposit was observed in 50% of the patients in group 1 and 64% of the patients in group 2 (P <.01). According to the Constant score, ratings increased from 48 to 71 points in group 1 (P <.001) and from 53 to 88 in group 2 (P <.001) (out of a total possible 100 points), the end values of both groups differing significantly (P <.01). After 24 weeks, 52% of the patients in group 1 rated the results of treatment as good or excellent, compared with 68% in group 2 (P <.01). No improvement was reported by 24% versus 10%, respectively, at the 24-week follow-up. (J Shoulder Elbow Surg 1998;7:505-9.)