Surgery for calcifying tendinitis of the shoulder: A systematic review

Table 1 PICO search strategy

Population	Patients with radiographically confirmed symptomatic tendinitis calcarea of the shoulder (search terms: Shoulder joint, rotator cuff, shoulder, supraspinatus, infraspinatus, subscapular or teres, impingement syndrome, tendinopathy, tendonitis or tendinitis, tendinosis, calcinosis, calcifying, calcification, calcified, calcific, calcarea)
Intervention	Surgery (search terms: Surgery, surgical, orthopaedic surgery, shoulder surgery, acromioplasty, debridement, bursectomy, arthroscopic, Neer)
Comparison	Surgery (search terms: Surgery, surgical, orthopaedic surgery, shoulder surgery, acromioplasty, debridement, bursectomy, arthroscopic, Neer)
Outcome	Functional and clinical outcome
Limits	Language: English, German, Dutch Publication year: 1996-2016 Human

Table 2 Characteristics of the included studies

Ref.	Study design (LoE)	Population	Mean age (range)	Duration of symptoms in months (range)	Interventions	Outcome measures	Findings
							Baseline	Follow-up
Rubenthaler et al[10]	RCT (II)	38	51.1 (-)	-	Arthroscopic debridement + acromioplasty vs Open debridement + acromioplasty	Patte score, VAS, CMS	No significant baseline differences	16 mo: CMS: 86.0 vs 85.3 (NS) VAS: 1.4 vs 1.8 (NS) Patte score: 84.4 vs 84.6 (NS)
Clement et al[11]	RCT (II)	80	49 (32-75)	6.2 (-)	Arthroscopic debridement + acromioplasty vs arthroscopic debridement	VAS, DASH, CMS, SF-12	No significant baseline differences	6 wk: CMS: 62.2 vs 64.1 (NS) DASH: 24.5 vs 24.0 (NS) VAS: 4.4 vs 4.5 (NS) SF-12: 45.7 vs 44.3 (NS) 12 mo: CMS: 82.4 vs 77.5 (NS) DASH: 14.5 vs 14.0 (NS) VAS: 1.6 vs 2.5 (NS) SF-12: 43.0 vs 42.5 (NS)
Hofstee et al[12]	Quasi-RCT (III)	40	52.3 (41-62	14.5 (6-36)	Arthroscopic debridement + acromioplasty vs arthroscopic debridement	DASH, VAS, satisfaction, ROM	No significant baseline differences	36 mo: DASH: 3.14 vs 3.04 (NS) VAS: 4.3 vs 4.2 satisfied, yes: 80% vs 75%
Marder et al[13]	Retrospective case-control study (III)	50	44 (27-67)	13 (-)	Arthroscopic debridement vs arthroscopic debridement + acromioplasty	QuickDASH, RTW, UCLA	No significant baseline differences	6 wk: RTW: 60% vs 20% (P = 0.004) 5 yr: QuickDASH: 6.3 vs 11.1 (NS) VAS: not well recorded UCLA: 32.0 vs 32.4 (NS)
Tillander et al[14]	Matched pair analysis (III)	50	50 (40-67)	66 (12-216)	Arthroscopic acromioplasty in patients with vs without CT	CMS, satisfaction, radiological	No significant baseline differences	24 mo: CMS: 78 vs 79 (NS) Satisfaction, yes: 72% vs 80% (NS)
Maier et al[15]	Comparative cohort study (III)	36	48.9 (29-70)	35.2 (9-84)	Open debridement vs open debridement + acromioplasty	CMS	No significant baseline differences	34 mo: CMS: 74.9 vs 73.4 (NS)

RCT: Randomized controlled trial; CMS: Constant-Murley score; DASH: Disabilities of Arm, Shoulder and Hand score; VAS: Visual Analog Scale for pain; UCLA: University of California-Los Angeles score; RTW: Return to work; -: No information available in included study; NS: Not significant.

Table 3 Methodological quality scores of the individual included randomized controlled trial’s and qausi-randomized controlled trial

Ref.	Adequate randomization?	Allocation concealment?	Blinding patients?	Blinding caregiver?	Blinding outcome assessors?	Incomplete outcome data addressed? dropouts	Incomplete outcome data? ITT-analysis?	No selective outcome reporting?
Rubenthaler et al[10]	+	+	+	-	?	+	-	+
Clement et al[11]	+	+	+	-	+	+	-	+
Hofstee et al[12]	-	-	?	-	?	+	-	+

12 quality criteria of Furlan et al[8]. +: Yes = 1 point; -: No = 0 points; ?: Unclear/unsure = 0 points. High-quality ≥ 50%, Low-quality ≤ 50%.

Table 4 Methodological quality scores of the individual included comparative cohort studies

Ref.	Selection (max = ****)	Comparability (max = **)	Exposure (max = ***)
Marder et al[13]	***	**	***
Tillander et al[14]	****	**	***
Maier et al[15]	***	**	***

Newcastle-Ottawa Scale[9].