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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 December;179(12):665-74

DOI: 10.23736/S0393-3660.20.04535-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Combination of laser needling and hyaluronic acid infiltration treatments for rotator cuff calcific tendinopathies

Maria CONFORTI

FP3 Center, Bergamo, Italy



BACKGROUND: This study illustrates the antalgic efficacy of a combination of infiltrative Sinovial® H-L Hybrid (IBSA, Lugano, Switzerland) followed by low-thermal impact multi-frequency intra-articular laser therapy (laser needling), preceded or less by percutaneous needle aspiration (US-PICT), in the treatment of calcific tendinopathies of the shoulder.
METHODS: Sinovial® H-L is a formulation of non-chemically modified stable, cooperative hybrid hyaluronic acid complexes characterized by high fluidity and excellent tolerability in both the intra- and the extra-articular setting. The innovative laser needling technique was performed with a 4-λ AG08 INTRA Laser FP3 System® device (Touch Life Rehab, Bergamo, Italy). Both infiltration treatments were ultrasound-guided, with the added antalgic benefit of precisely targeting affected and/or inflamed tissues.
RESULTS: A homogeneous group of 97 subjects was selected over the course of 4 years (February 2016-January 2020) among patients treated for symptomatic calcific tendinopathy of the shoulder at the FP3 Motor Rehabilitation Clinic of Bergamo (Italy); inclusion criteria were the clinical and ultrasonographic confirmation of diagnosis. Pain assessment was subjectively quantified via visual analog scale (VAS) and in terms of its impact on activities of daily living via the American shoulder and elbow surgeons (ASES) scale. Patients were evaluated at baseline (i.e. at the time of the first sitting [T0]; at the end of treatment [T1], i.e. after two/three infiltration sittings; at their return to work and/or regular sport activity [T2]; and at three months post-treatment [T3]). During the treatment, the therapeutic use of pain-relieving or anti-inflammatory medication or of other electromedical equipment was not permitted, except for paracetamol the day after infiltration treatment.
CONCLUSIONS: Our results suggest intra-articular FP3 System® multifrequency laser treatment combined with Sinovial® H-L infiltrations is effective in treating patients suffering from calcific tendinopathy of the shoulder, with or without prior percutaneous dissolution of calcifications, proving sufficient on its own for the resolution of acute disease. No cases of adhesive capsulitis were recorded with this method.


KEY WORDS: Tendinopathy; Laser therapy; Lasers

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