AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MED...AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MEDLINE(through PubMed), EMBASE(through OVID), CINAHL(through EBSCO), Web of Science and Cochrane Central Register of Controlled Trials were systematically searched in May 2016. Eligible for inclusion were all available studies with level Ⅱ and level Ⅲ evidence(LoE). Data was assessed and extracted by two independent review authors using a specifically for this study designed data extraction form.RESULTS Six studies(294 surgically treated shoulders) were included in this review. No significant differences between the three available treatment options(acromioplasty with the removal of the calcific deposits, acromioplasty or solely the removal of the calcific deposits) were detected regarding the functional and clinical outcome. The followup ranged from 12 mo to 5 years. Complication rates were low. No reoperations were necessary and the only reported complication was adhesive capsulitis, which in all cases could be treated conservatively with full recovery. CONCLUSION We found that all three available treatment options show good functional and clinical outcomes in the short and midterm. However, a favorable procedure is difficult to determine due to the lack of high-quality comparing studies.展开更多
BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears....BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears.However,it is difficult to obtain a high-quality true anteroposterior(AP)radiograph of the shoulder,with any excess scapular version or flexion/extension resulting in deviation from the true CSA value.Three-dimensional(3D)bony reconstructions of computed tomography(CT)shoulder scans may be able to be rotated to obtain a similar view to that of true AP radiographs.AIM To compare CSA measurements performed on 3D bony CT reconstructions,with those on corresponding true AP radiographs.METHODS CT shoulder scans were matched with true AP radiographs that were classified as either Suter-Henninger type A or C quality.3D bony reconstructions were segmented from the CT scans,and rotated to replicate an ideal true AP view.Two observers performed CSA measurements using both CT and radiographic images.Measurements were repeated after a one week interval.Reliability was assessed using intraclass correlation coefficients(ICCs)and Bland-Altman plots[bias,limits of agreement(LOA)].RESULTS Twenty CT shoulder scans were matched.The mean CSA values were 32.55°(±4.26°)with radiographs and 29.82°(±3.49°)with the CT-based method[mean difference 2.73°(±2.86°);P<0.001;bias+2.73°;LOA-2.17°to+7.63°].There was a strong correlation between the two methods(r=0.748;P<0.001).Intra-observer reliability was similar,but the best intra-observer values were achieved by the most experienced observer using the CT-based method[ICC:0.983(0.958-0.993);bias+0.03°,LOA-1.28°to+1.34°].Inter-observer reliability was better with the CT-based method[ICC:0.897(0.758-0.958),bias+0.24°,LOA-2.93°to+3.41°].CONCLUSION The described CT-based method may be a suitable alternative for critical shoulder angle measurement,as it overcomes the difficulty in obtaining a true AP radiographic view.展开更多
文摘AIM To systematically search literature and determine a preferable surgical procedure in patients with failed conservative treatment of calcifying tendinitis of the shoulder.METHODS The electronic online databases MEDLINE(through PubMed), EMBASE(through OVID), CINAHL(through EBSCO), Web of Science and Cochrane Central Register of Controlled Trials were systematically searched in May 2016. Eligible for inclusion were all available studies with level Ⅱ and level Ⅲ evidence(LoE). Data was assessed and extracted by two independent review authors using a specifically for this study designed data extraction form.RESULTS Six studies(294 surgically treated shoulders) were included in this review. No significant differences between the three available treatment options(acromioplasty with the removal of the calcific deposits, acromioplasty or solely the removal of the calcific deposits) were detected regarding the functional and clinical outcome. The followup ranged from 12 mo to 5 years. Complication rates were low. No reoperations were necessary and the only reported complication was adhesive capsulitis, which in all cases could be treated conservatively with full recovery. CONCLUSION We found that all three available treatment options show good functional and clinical outcomes in the short and midterm. However, a favorable procedure is difficult to determine due to the lack of high-quality comparing studies.
文摘BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears.However,it is difficult to obtain a high-quality true anteroposterior(AP)radiograph of the shoulder,with any excess scapular version or flexion/extension resulting in deviation from the true CSA value.Three-dimensional(3D)bony reconstructions of computed tomography(CT)shoulder scans may be able to be rotated to obtain a similar view to that of true AP radiographs.AIM To compare CSA measurements performed on 3D bony CT reconstructions,with those on corresponding true AP radiographs.METHODS CT shoulder scans were matched with true AP radiographs that were classified as either Suter-Henninger type A or C quality.3D bony reconstructions were segmented from the CT scans,and rotated to replicate an ideal true AP view.Two observers performed CSA measurements using both CT and radiographic images.Measurements were repeated after a one week interval.Reliability was assessed using intraclass correlation coefficients(ICCs)and Bland-Altman plots[bias,limits of agreement(LOA)].RESULTS Twenty CT shoulder scans were matched.The mean CSA values were 32.55°(±4.26°)with radiographs and 29.82°(±3.49°)with the CT-based method[mean difference 2.73°(±2.86°);P<0.001;bias+2.73°;LOA-2.17°to+7.63°].There was a strong correlation between the two methods(r=0.748;P<0.001).Intra-observer reliability was similar,but the best intra-observer values were achieved by the most experienced observer using the CT-based method[ICC:0.983(0.958-0.993);bias+0.03°,LOA-1.28°to+1.34°].Inter-observer reliability was better with the CT-based method[ICC:0.897(0.758-0.958),bias+0.24°,LOA-2.93°to+3.41°].CONCLUSION The described CT-based method may be a suitable alternative for critical shoulder angle measurement,as it overcomes the difficulty in obtaining a true AP radiographic view.
