scholarly journals Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials

2019 ◽  
Vol 5 (1) ◽  
pp. e000506 ◽  
Author(s):  
Simon Lafrance ◽  
Patrick Doiron-Cadrin ◽  
Marie Saulnier ◽  
Martin Lamontagne ◽  
Nathalie J Bureau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Ultrasound Guided ◽  
Calcific Tendinopathy ◽  
Shockwave Therapy ◽  
Randomised Control Trials

BackgroundRotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy remains inconclusive. The aim of this systematic review and meta-analysis is to update the available evidence on the efficacy of ultrasound-guided lavage in adults with rotator cuff calcific tendinopathy.MethodsA literature search was conducted up to April 2018 in four bibliographic databases to identify randomised control trials that compared ultrasound-guided lavage alone with other interventions to treat rotator cuff calcific tendinopathy. Randomised control trials were assessed with the Cochrane Risk of Bias Tool. Meta-analyses and/or qualitative synthesis of the evidence were performed.ResultsThree randomised control trials were included. Pooled results for pain (n=226) indicated that ultrasound-guided lavage may significantly decrease pain when compared with shockwave therapy, with a mean difference of −1.98 out of 10 points (95% CI −2.52 to −1.45) in the short term and of −1.84 (95% CI −2.63 to −1.04) in the long term. Based on one trial (n=25), ultrasound-guided lavage significantly improved function when compared with shockwave therapy (p<0.05). Based on another trial (n=48), the addition of ultrasound-guided lavage to a corticosteroid injection significantly improves function in the long term (p<0.05).ConclusionFor individuals with rotator cuff calcific tendinopathy, low-quality evidence suggests that ultrasound-guided lavage is more effective than shockwave therapy or a corticosteroid injection alone. Future trials could modify the present conclusions.Trial registration numberCRD42018095858.

scholarly journals Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Fu-An Yang ◽  
Ya-Chu Shih ◽  
Jia-Pei Hong ◽  
Chin-Wen Wu ◽  
Chun-De Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Randomized Controlled Trials ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Tunnel Syndrome

Abstract Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. Randomized controlled trials (RCTs) were identified, and data collection was completed on 7 October 7, 2020. Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD = −0.49, 95% CI (−0.74, −0.25), P < 0.0001], Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD = −0.24, 95% CI (−0.42, −0.06), P = 0.01], distal motor latency [SMD = −0.36, 95% CI (−0.70, −0.02), P = 0.04], and compound muscle action potential [SMD = 0.38, 95% CI (0.16, 0.61), P = 0.0008] . Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

scholarly journals Conservative treatment of partial-thickness rotator cuff tears and tendinopathy with platelet-rich plasma: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Na Xiang ◽  
Jie Deng ◽  
Yan Liu ◽  
Xi Yu ◽  
Biao Cheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Rotator Cuff Tears ◽  
Short Term ◽  
Partial Thickness ◽  
And Function

AbstractPurposeTo assess the effect of platelet-rich plasma (PRP) as a conservative therapy on individuals with partial-thickness rotator cuff tears (PTRCs) or tendinopathy in terms of pain, and function.MethodsA systematic review and meta-analysis of randomized controlled trials were conducted. Short-term (6±1 months) and long-term (≥1 year) outcomes were analysed, including the visual analogue scale (VAS), Constant-Murley score (CMS), Shoulder Pain and Disability Index (SPADI), as well as American Shoulder and Elbow Surgeons (ASES) score. The weighted mean difference (MD) with 95% confidence interval (CI) was used.ResultsTen studies were eligible in this review, nine studies with 561 patients were included in this meta-analysis. The meta-analysis showed statistically significant differences in the decrease in short-term VAS (MD=-1.56; 95% CI -2.82 to -0.30), and increase in CMS (MD=16.48; 95% CI 12.57 to 20.40), and SPADI (MD=-18.78 95% CI -36.55 to -1.02). Nonetheless, no long-term effect was observed on pain and function, except CMS (MD=24.30). The results of mean important differences (MIDs) reached the minimal clinically important differences, except ASES. For subgroup analysis, short-term VAS scores were decreased in PRP-treated patients with double centrifugation (MD=-1.99), single injection (MD=-0.71) and post-injection rehabilitation (MD=-1.59).ConclusionPRP-treated patients with PTRCs and rotator cuff tendinopathy demonstrated improvements in pain and function, although the effect may not last for a long time. Overall, our results suggest that PRP may have positive clinical outcomes, but limited data, and study heterogeneity hinder firm conclusions.

scholarly journals Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fu-An Yang ◽  
Ya-Chu Shih ◽  
Jia-Pei Hong ◽  
Chin-Wen Wu ◽  
Chun-De Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Randomized Controlled Trials ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Tunnel Syndrome

AbstractCarpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. A search of the PubMed, Cochrane Library, and Embase databases was performed from the date of their inception to October 7, 2020 to identify randomized controlled trials (RCTs). Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results than landmark-guided injection for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD =  − 0.43, 95% CI (− 0.68, − 0.19), P = 0.0005] and Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD =  − 0.50, 95% CI (− 0.84, − 0.15), P = 0.005]. Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

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