{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:31:10Z","timestamp":1787319070930,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"\n Purpose<\/jats:title>\n To compare the midterm clinical and radiographic outcomes of extracorporeal shockwave therapy (ESWT) and ultrasound\u2010guided needling (UGN) in symptomatic calcific tendinitis of the rotator cuff (RCCT).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study is a follow\u2010up of a randomized controlled trial. Eighty\u2010two patients with shoulder complaints due to RCCT (>5\u2009mm in size, G\u00e4rtner type I\u2010II) persisting >4\u2009months despite nonoperative treatment, including a subacromial corticosteroid injection, were allocated to ESWT (4 sessions of high\u2010energy ESWT) or UGN (single ultrasound\u2010guided puncture and lavage using two 17\u2010gauge needles). Outcomes at 5\u2009years were the Constant\u2010Murley Score (CMS), Disabilities of the Arm, Shoulder, and Hand questionnaire, and visual analog scale for pain. Radiographs were used to evaluate the size, location, morphology, and recurrence of the deposits.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The minimum follow\u2010up in this study was 5\u2009years (mean 6.8\u2009\u00b1\u20091.1\u2009years; range 60\u2010106\u2009months). Sixty\u2010seven (82%) of the original 82 patients were included (43 females; 64%, mean age 51.8\u2009\u00b1\u20099.0\u2009years). Baseline CMS was 67.4\u2009\u00b1\u200912.5. At 5\u2009years, the mean CMS was 94.4\u2009\u00b1\u20096.4 and 93.3\u2009\u00b1\u200913.6 for ESWT and UGN, respectively (\n P<\/jats:italic>\n \u2009=\u2009.67). Ninety\u2010four percent of both groups achieved the minimal clinically important difference threshold value for CMS. Additional treatment was received by 42% and 26% of ESWT and UGN, respectively (\n P<\/jats:italic>\n \u2009=\u2009.17). No recurrence of calcific deposits was found in treated tendons. New deposits in a different rotator cuff tendon were observed in 15% of UGN patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients with RCCT treated with ESWT and UGN show excellent midterm clinical and radiographic outcomes, with most achieving clinically important difference threshold values without significant intergroup differences. Both treatment groups showed high rates of additional treatments with the potential of underpowered analysis.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level II, randomized controlled trial.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/arj.70405","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:09:38Z","timestamp":1784894978000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparable Midterm Outcomes for Ultrasound\u2010Guided Needling Versus High\u2010Energy Shockwave Therapy for Rotator Cuff Calcific Tendinitis: A Randomized Controlled Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2551-4281","authenticated-orcid":false,"given":"Dominic M.","family":"van Noort","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Spaarne Gasthuis Hoofddorp Netherland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2534-7839","authenticated-orcid":false,"given":"Jan K. G.","family":"Louwerens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Spaarne Gasthuis Hoofddorp Netherland"},{"name":"Department of Orthopaedic Surgery Amphia Ziekenhuis Breda Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-9358","authenticated-orcid":false,"given":"Inger N.","family":"Sierevelt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Spaarne Gasthuis Hoofddorp Netherland"},{"name":"Department of Orthopaedic Surgery Xpert Clinics Amsterdam Netherlands"},{"name":"Department Orthopedic Surgery and Sports Medicine, Amsterdam UMC Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"van Noort","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Spaarne Gasthuis Hoofddorp Netherland"},{"name":"Department of Orthopaedic Surgery Erasmus MC Rotterdam 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