{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:14:25Z","timestamp":1790363665194,"version":"4.1.0"},"reference-count":72,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rotator cuff calcific tendinopathy is a leading cause of nontraumatic shoulder pain, frequently leading to articular and functional impairments, depicting an adhesive capsulitis\u2010like clinical presentation. To date, there is a lack of evidence on the impact of conservative approaches, and no gold standard has been established for managing rotator cuff calcific tendinopathy. This systematic review aimed to identify the most effective conservative approach for reducing pain and improving function in rotator cuff calcific tendinopathy patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Scopus, and Cochrane Library databases were systematically searched from their inception until January 2, 2025, for English\u2010language randomized clinical trials including adults affected by rotator cuff calcific tendinopathy undergoing conservative treatment. Data extraction was performed independently by two reviewers using a customized data extraction form, with consensus reached by a third reviewer. A network meta\u2010analysis was subsequently carried out to compare the efficacy of different interventions. The risk of bias within the included randomized clinical trials was assessed using Version 2 of the Cochrane risk\u2010of\u2010bias tool for randomized trials. The study has been registered with PROSPERO, registration number CRD420250650833.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen articles were included. This study identified 1160 subjects affected by rotator cuff calcific tendinopathy. A pairwise comparison through a network meta\u2010analysis indicated that platelet\u2010rich plasma exhibited the highest probability (85%) of improving shoulder function, followed by disodium ethylenediamine tetra\u2010acetic acid at 75%, aspiration techniques at 65%, and extracorporeal shockwave therapy at 57%. Regarding pain reduction, disodium ethylenediamine tetra\u2010acetic acid showed the highest probability (66%), followed by kinesiotaping and needle aspiration, both at 61%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This systematic review and network meta\u2010analysis identified several interventional techniques, including platelet\u2010rich plasma and disodium ethylenediamine tetra\u2010acetic acid injections, extracorporeal shockwave therapy, and needle aspiration, as more effective strategies for reducing pain and improving function in subjects affected by rotator cuff calcific tendinopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>I (systematic review of Level\u2010I randomized controlled studies).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70175","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T13:59:52Z","timestamp":1758895192000},"page":"3048-3066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Conservative Approaches on Pain Relief and Function in Patients With Rotator Cuff Calcific Tendinopathy: Which Is the Best Option? A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"17","author":[{"given":"Lucrezia","family":"Moggio","sequence":"first","affiliation":[{"name":"Rehabilitation Unit, Ospedale Degli Infermi  Biella Italy"},{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5568-7909","authenticated-orcid":false,"given":"Nicola","family":"Marotta","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"},{"name":"Department of Experimental and Clinical Medicine University of Catanzaro \u201cMagna Graecia\u201d  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"de Sire","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"},{"name":"Department of Medical and Surgical Sciences University of Catanzaro \u201cMagna Graecia\u201d  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia Lucia","family":"Benedetto","sequence":"additional","affiliation":[{"name":"Stem Cell Laboratory, Department of Medical and Surgical Sciences Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Gasparini","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"},{"name":"Department of Medical and Surgical Sciences Magna Graecia University, Orthopaedic and Trauma Surgery, R. Dulbecco University Hospital  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ammendolia","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"},{"name":"Department of Medical and Surgical Sciences University of Catanzaro \u201cMagna Graecia\u201d  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8145-3623","authenticated-orcid":false,"given":"Elvira Immacolata","family":"Parrotta","sequence":"additional","affiliation":[{"name":"Stem Cell Laboratory, Department of Medical and Surgical Sciences Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-5612","authenticated-orcid":false,"given":"Michele","family":"Mercurio","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealthatUMG Magna Graecia University  Catanzaro Italy"},{"name":"Department of Medical and Surgical Sciences Magna Graecia University, Orthopaedic and Trauma Surgery, R. 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