{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:56:49Z","timestamp":1791550609749,"version":"4.3.4"},"reference-count":48,"publisher":"BMJ","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008556","name":"Aase Bye og Trygve J. B. Hoffs Fond til Vitenskapelig, Medisinsk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008556","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare treatment effects between ultrasound guided lavage with corticosteroid injection and sham lavage with and without corticosteroid injection in patients with calcific tendinopathy of the shoulder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pragmatic, three arm, parallel group, double blinded, sham controlled, randomised, superiority trial with repeated measurements over 24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Six hospitals in Norway and Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>220 adults with calcific tendinopathy of the shoulder, persistent for at least three months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Ultrasound guided deposit lavage plus subacromial injection of 20 mg triamcinolone acetonide and 9 mL 1% lidocaine hydrochloride (lavage+steroid); sham lavage plus subacromial injection of 20 mg triamcinolone acetonide and 9 mL 1% lidocaine hydrochloride (sham lavage+steroid); or sham lavage plus subacromial injection of 10 mL 1% lidocaine hydrochloride (sham). All patients received a physiotherapeutic treatment regimen consisting of four home exercises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was the result on the 48 point scale (0=worst; 48=best) of the Oxford Shoulder Score (OSS) at four month follow-up. Secondary outcomes included measurements on the short form of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and of pain intensity up to 24 months. The influence of the size of the deposit at baseline and of the persistence or disappearance of the deposit was investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 218 (99%) participants were included in the primary analysis. Differences between groups on the OSS at four months were not significant: lavage+steroid versus sham 0.2 (95% confidence interval \u22122.3 to 2.8; P=1.0); sham lavage+steroid versus sham 2.0 (\u22120.5 to 4.6; P=0.35); lavage+steroid versus sham lavage+steroid \u22121.8 (\u22124.3 to 0.7; P=0.47). After four months, 143 patients with insufficient treatment effect received supplementary treatment. At 24 months, none of the study procedures was superior to sham. No serious adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found no benefit for ultrasound guided lavage with a corticosteroid injection or for sham lavage with a corticosteroid injection compared with sham treatment in patients with calcific rotator cuff tendinopathy of the shoulder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      NCT02419040EudraCT 2015-002343-34; Ethical committee Norway 2015-002343-34; Ethical committee Sweden 2015\/79-31; Clinicaltrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02419040\">NCT02419040<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-076447","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T20:00:18Z","timestamp":1697054418000},"page":"e076447","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study"],"prefix":"10.1136","volume":"383","clinical-trial-number":[{"clinical-trial-number":"nct02419040","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2518-7599","authenticated-orcid":false,"given":"Stefan","family":"Moosmayer","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Martina Hansens Hospital, Gjettum, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole Marius","family":"Ekeberg","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Helse Fonna HF Stord Hospital, Stord, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna Bj\u00f6rnsson","family":"Hallgren","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Link\u00f6ping University Hospital, Link\u00f6ping, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingar","family":"Heier","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Vestfold Hospital, Stavern, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Synn\u00f8ve","family":"Kvalheim","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevaal, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Gunnar","family":"Juel","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevaal, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper","family":"Blomquist","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Haraldsplass Deaconess Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Are Hugo","family":"Pripp","sequence":"additional","affiliation":[{"name":"Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital and Oslo Metropolitan University, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Ivar","family":"Brox","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevaal, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"2025110102283127000_383.oct11_7.e076447.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.02.024"},{"key":"2025110102283127000_383.oct11_7.e076447.2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00417"},{"key":"2025110102283127000_383.oct11_7.e076447.3","first-page":"1","article-title":"Peridentinis calcarea: common disease of middle life. 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