nach oben

Archives of Orthopaedic and Trauma Surgery

Erschienen in:

17.02.2022 | Arthroscopy and Sports Medicine

Arthroscopic treatment and subacromial decompression of calcific tendinitis without removal of the calcific deposit results in rapid resolution of symptoms and excellent clinical outcomes in commercial airline pilots and cabin crew

verfasst von: Erik Hohmann, Kevin Tetsworth

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to report the results of subacromial arthroscopic decompression (SAD) without removal of the calcific deposits in patients with calcifying tendinitis.

Methods

All patients between 2016 and 2019 were included if they were aged between 18 and 60 years and had an isolated calcific deposit. The Constant–Murley score (CMS), Disabilities of the Arm, Shoulder and Hand (Quick DASH) score, the Shoulder Pain and Disability Index (SPADI), the simple shoulder test (SST), and the single assessment numeric evaluation (SANE) were used for assessment. Time to return to work was recorded.

Results

24 patients (13 pilots, 11 cabin crew) with a mean age of 47.1 ± 7.8 years were included. Quick Dash improved from 68.8 preoperative, to 8.4 at 3 months, and 0.1 at 24 months. CMS improved from 37.4 preoperative, to 83 at 3 months, and 94 at 24 months. SPADI improved from 73.8 preoperative, to 5.4 at 3 months, and 1 at 24 months. SST improved from 22.5 preoperative, to 94.2 at 3 months, and 100 at 24 months. SANE improved from 33.5 preoperative, to 78.7 at 3 months, and 95.6 at 24 months. MCID, SCB, and PASS reached values above 83% at 3 months and 100% at 6 months, with the exception of SANE which reached 29% at 3 months and plateaued to 96% at 6 months. The mean time to return to work was 7.1 ± 2.1 weeks. Pilots returned at a mean of 6.9 ± 1.8 weeks; cabin crew returned to work at a mean of 7.8 ± 2.5 weeks.

Conclusions

The results of this study suggest excellent short- and mid-term clinical outcomes can be achieved in patients with calcific tendinitis undergoing arthroscopic debridement and subacromial decompression without removal of calcific deposits. In this patient population, early surgical intervention was a potentially viable alternative to nonoperative treatment, and allowed early return to work.

Merolla G, Singh S, Paladini P, Porcellini G (2016) Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment. J Orthopaed Traumatol 17:7–14. https://doi.org/10.1007/s10195-015-0367-6CrossRef

Bosworth BM (1941) Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA 116:2477–2482CrossRef

Sansone V, Maiorano E, Galluzzo A, Pascale V (2018) Calcific tendinitis of the shoulder: clinical perspectives into the mechanisms, pathogenesis and treatment. Orthop Res Rev 10:63–72. https://doi.org/10.2147/ORR.S138225CrossRefPubMedPubMedCentral

Chiou HJ, Hung SC, Lin SH, Wei YS, Li MJ (2010) Correlation among mineral components, progressive calcification process and clinical symptoms of calcific tendonitis. Rheumatology 49:548–565. https://doi.org/10.1093/rheumatology/kep359CrossRefPubMed

Suzuki K, Potts A, Anakwenze O, Singh A (2014) Calcific tendinitis of the rotator cuff: management options. J Am Acad Orthop Surg 22(11):707–717. https://doi.org/10.5435/JAAOS-22-11-707CrossRefPubMed

Uhthoff HK, Loehr JW (1997) Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis and management. J Am Acad Orthop Surg 5(4):183–191. https://doi.org/10.5435/00124635-199707000-00001CrossRefPubMed

Merolla G, Bhat MG, Paladini P, Porcellini G (2015) Complications of calcific tendinitis of the shoulder: a concise review. J Orthop Traumatol 16(3):175–183. https://doi.org/10.1007/s10195-015-0339-xCrossRefPubMedPubMedCentral

Simpson M, Pizzari T, Cook T, Wildman S, Lewis J (2020) Effectiveness of non-surgical interventions for rotator cuff calcific tendinopathy: a systematic review. J Rehabil Med. https://doi.org/10.2340/16501977-2725CrossRefPubMed

Verstraelen FU, Fievez E, Janssen L, Morrenhof W (2017) Surgery for calcifying tendinitis of the shoulder: a systematic review. World J Orthop 8:424–430. https://doi.org/10.5312/wjo.v8.i5.424CrossRefPubMedPubMedCentral

10.

Castillo-Gonzalez FD, Ramos-Alvarez JJ, Rodrıguez-Fabián G, Gonzalez-Perez J, Calderon-Montero J (2014) Treatment of the calcific tendinopathy of the rotator cuff by ultrasound-guided percutaneous needle lavage. Two years prospective study. Muscles Ligaments Tendons J 4(2):220–225CrossRefPubMedPubMedCentral

11.

Lafrance S, Doiron-Cadrin P, Saulnier M, Lamontagne M, Bureau NJ, Dyer JO, Roy JS et al (2019) Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with meta-analysis of randomised controlled trials. BMJ Open Sport Exerc Med 5(1):e000506. https://doi.org/10.1136/bmjsem-2018-000506CrossRefPubMedPubMedCentral

12.

Frassanito P, Cavalieri C, Maestri R, Felicetti G (2018) Effectiveness of extracorporeal shock wave therapy and kinesio taping in calcific tendinopathy of the shoulder: a randomized controlled trial. Eur J Phys Rehabil Med 54(3):333–340. https://doi.org/10.23736/S1973-9087.17.04749-9CrossRefPubMed

13.

Ark JW, Flock TJ, Flatow EL, Bigliani LU (1992) Arthroscopic treatment of calcific tendinitis of the shoulder. Arthroscopy 8(2):183–188. https://doi.org/10.1016/0749-8063(92)90034-9CrossRefPubMed

14.

Jerosch J, Strauss JM, Schmiel S (1998) Arthroscopic treatment of calcific tendinitis of the shoulder. J Shoulder Elbow Surg 7(1):30–37. https://doi.org/10.1016/s1058-2746(98)90180-xCrossRefPubMed

15.

Porcellini G, Paladini P, Campi F, Paganelli M (2004) Arthroscopic treatment of calcifying tendinits of the shoulder: clinical and ultrasonographic follow-up at two to five years. J Shoulder Elbow Surg 13(5):503–508. https://doi.org/10.1016/j.jse.2004.04.001CrossRefPubMed

16.

Seil R, Litzenburger H, Kohn D, Rupp S (2006) Arthroscopic treatment of chronically painful calcifying tendinitis of the supraspinatus tendon. Arthroscopy 22(5):521–527. https://doi.org/10.1016/j.arthro.2006.01.012CrossRefPubMed

17.

Tillander BM, Norlin RO (1998) Change of calcifications after arthroscopic subacromial decompression. J Shoulder Elbow Surg 7(3):213–217. https://doi.org/10.1016/s1058-2746(98)90047-7CrossRefPubMed

18.

Medical advice on return to work with regards to musculoskeletal disordersw. https://www.hse.gov.uk/legislation/hswa.htm. Accessed 16 Nov 2021

19.

Easy access rules and regulations for medical requirements. European Union Aviation Safety Agency. https://www.easa.europa.eu/sites/default/files/dfu/Easy_Access_Rules_for_Medical_Requirements.pdf. Accessed 23 Jun 2021

20.

Guide for aviation medical examiners. Synopsis of Medical Standards. Federal Aviation Administration. https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf. Accessed 23 Jun 2021

21.

Vrotsou K, Avila M, Machon M, Mateo-Abad M, Pardo Y, Garin O et al (2018) Constant-Murley score: systematic review and standardised evaluation in different shoulder pathologies. Qual Life Res 27(9):2217–2226. https://doi.org/10.1007/s11136-018-1875-7CrossRefPubMedPubMedCentral

22.

Gummesson C, Atroshi I, Ekdahl C (2003) The disabilities of the arm, should and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord 16:11. https://doi.org/10.1186/1471-2474-4-11CrossRef

23.

Hill CL, Lester S, Taylor AW, Shanahan ME, Gill TK (2011) Factor structure and validity of the shoulder and disability index in a population-based study of people with shoulder symptoms. BMC Musculoskeletal Disord 12:8. https://doi.org/10.1186/1471-2474-12-8CrossRef

24.

Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M (2007) Reliability, validity and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg 16(3):260–267. https://doi.org/10.1016/j.jse.2006.07.003CrossRefPubMed

25.

Neto JOB, Gesser RL, Steglich V, Ferreira APB, Gandhi M, Vissoci JRN et al (2013) Validation of the simple shoulder test in a Portugese-Brazilian population. Is latent variable structure and validation of the simple shoulder test stable across cultures? PLoS ONE 8(5):e62890. https://doi.org/10.1371/journal.pone.0062890CrossRefPubMedPubMedCentral

26.

O’Connor CM, Ring D (2019) Correlation of single assessment numeric evaluation (SANE) with other patient reported outcomes. Arch Bone Jt Surg 7(4):303–306. https://doi.org/10.22038/ABJS.2018.33884.1888CrossRefPubMedPubMedCentral

27.

Thigpen CA, Shanley E, Momaya AM, Kissberth MJ, Tolan SJ, Tokish JM et al (2018) Validity and responsiveness of the single alpha-numeric evaluation for shoulder patients. Am J Sports Med 46(14):3480–3485. https://doi.org/10.1177/0363546518807924CrossRefPubMed

28.

Wickham JR, Lay BC, Scribani MB, Wittstein JR (2020) Single assessment numeric evaluation (SANE) correlates with American Shoulder and Elbow Surgeons score and Western Ontario Rotator Cuff index in patients undergoing arthroscopic rotator cuff repair. J Shoulder Elbow Surg 29(2):363–369. https://doi.org/10.1016/j.jse.2019.07.013CrossRef

29.

Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (1999) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Outcome measures after shoulder surgery. Am J Sports Med 27(2):214–221. https://doi.org/10.1177/03635465990270021701CrossRefPubMed

30.

Cvetanovich GL, Gowd AK, Liu JN, Nwachuku BU, Cabarcas BC, Cole BJ et al (2019) Establishing clinically significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 28:939–948. https://doi.org/10.1016/j.jse.2018.10.013CrossRefPubMed

31.

Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G (2014) Minimal clinically important differences of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). J Orthop Sports Phys Ther 44(1):30–39. https://doi.org/10.2519/jospt.2014.4893CrossRefPubMed

32.

Louwerens JKG, van den Bekerom MPJ, van Royen BJ, Eygendaal D, van Noort A, Sierevelt IN (2020) Quantifying the minimal and substantial clinical benefit of the Constant-Murley score and the Disabilities of the Arm, Shoulder and Hand score in patients with calcific tendinitis of the shoulder. JSES Int 4(3):606–611. https://doi.org/10.1016/j.jseint.2020.05.001CrossRefPubMedPubMedCentral

33.

Christie A, Dagfinrud H, Garrat AM, Osnes HR, Hagen KB (2011) Identification of shoulder specific patient acceptable symptom state in patients with rheumatic diseases undergoing shoulder surgery. J Hand Therapy 24(1):53–60. https://doi.org/10.1016/j.jht.2010.10.006CrossRef

34.

Simovitch R, Flurin PH, Wright T, Zuckermann JD, Roche CP (2018) Quantifying success after total shoulder arthroplasty: the substantial clinical benefit. J Shoulder Elbow Surg 27(5):903–911. https://doi.org/10.1016/j.jse.2017.12.014CrossRefPubMed

35.

Tashjian RZ, Deloach J, Green A, Porucznik CA, Powell AP (2010) Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease. J Bone Jt Surg Am 92(2):296–303. https://doi.org/10.2106/JBJS.H.01296CrossRef

36.

Chamberlain AM, Hung M, Chen W (2017) Determining the patient acceptable state for the American Shoulder and Elbow Surgeons score, Simple Shoulder Test and visual analog score (VAS) after total shoulder arthroplasty. J Shoulder Elbow Surg 26(1):144–148. https://doi.org/10.1177/2471549217720042CrossRefPubMed

37.

Roy JS, MacDermid JC, Woodhouse LJ (2009) Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum 61(5):623–632. https://doi.org/10.1002/art.24396CrossRefPubMed

38.

Okohora KR, Lu Y, Nwachuku BU, Beletsky A, Patel BH, Verma NN et al (2020) How should we define clinically significant improvement on patient-reported outcomes measurement information system tests for patients undergoing meniscal surgery? Arthroscopy 36(1):241–250. https://doi.org/10.1016/j.arthro.2019.07.036CrossRef

39.

Nicholson GP (2003) Arthroscopic acromioplasty: a comparison between worker’s compensation and non-workers’ compensation populations. J Bone Jt Surg Am 85(4):682–689CrossRef

40.

McClelland D, Paxinos A, Dodenhoff RM (2005) Rate of return to work and driving following arthroscopic subacromial decompression. ANZ J Surg 75(9):747–749. https://doi.org/10.1111/j.1445-2197.2005.03529.xCrossRefPubMed

41.

Charalambous CP, Sahu A, Alvi F, Batra S, Gullett TK, Ravenscroft M (2010) Rate of return to work and driving following arthroscopic subacromial decompression and acromio-clavicular joint excision. Shoulder Elbow 2:83–86. https://doi.org/10.1111/j.1758-5740.2010.00048.xCrossRef

42.

Jayasekara M, Lam PH, Murrell GAC (2020) Return to work following shoulder surgery. An analysis of 1,773 cases. JBJS Open Access 5(3):e19.00081. https://doi.org/10.2106/JBJS.OA.19.00081CrossRefPubMedPubMedCentral

43.

Marder RA, Heiden EA, Kim S (2011) Calcific tendonitis of the shoulder: is subacromial decompression in combination with removal of the deposit beneficial? J Shoulder Elbow Surg 20(6):955–960. https://doi.org/10.1016/j.jse.2010.10.038CrossRefPubMed

44.

Pieterse R (2015) Workplace injuries in flight attendants. Assessing fitness to resume flying duties. In: Proceedings of the 86th AsMA annual scientific meeting of the aerospace medical association, Orlanda, Florida

45.

Cho NS, Lee BG, Rhee YG (2010) Radiologic course of the calcific deposits in calcific tendinitis of the shoulder. Does the initial radiologic aspect affect the final results? J Shoulder Elbow Surg 19(2):267–272. https://doi.org/10.1016/j.jse.2009.07.008CrossRefPubMed

46.

Contreras F, Brown HC, Marx RG (2013) Predictors of success for corticosteroid injection for management of rotator cuff disease. HSS J 9(1):2–5. https://doi.org/10.1007/s11420-012-9316-6CrossRefPubMedPubMedCentral

47.

Ogon P, Suedkamp NP, Jaeger M, Izadpanah K, Koestler W, Maier D (2009) Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder. Arthritis Rheum 60(10):2978–2984. https://doi.org/10.1002/art.24845CrossRefPubMed

48.

Bechay J, Lawrence C, Namdari S (2020) Calcific tendinopathy of the rotator cuff: a review of operative versus nonoperative management. Phy Sportsmed 48(3):241–246. https://doi.org/10.1080/00913847.2019.1710617CrossRef

49.

Sabeti M, Schmidt M, Ziai P, Graf A, Nemecek E, Schueller-Weidekamm C (2014) The intraoperative use of ultrasound facilitates significantly the arthroscopic debridement of calcific rotator cuff tendinitis. Arch Orthop Trauma Surg 134(5):651–656. https://doi.org/10.1007/s00402-014-1927-6CrossRefPubMed

50.

Clement N, Watts A, Phillips C, Mcbirnie JM (2015) Short-term outcome after arthroscopic bursectomy debridement of rotator cuff calcific tendonopathy with and without subacromial decompression: a prospective randomized controlled trial. Arthroscopy 31(9):1680–1687. https://doi.org/10.1016/j.arthro.2015.05.015CrossRefPubMed

51.

Wittenberg RH, Rubenthaler F, Wölk T, Ludwig J, Willburger RE, Steffen R (2001) Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis—a matched-pair analysis of 100 patients. Arch Orthop Traum Surg 121(1–2):56–59. https://doi.org/10.1007/s004020000195CrossRef

Titel: Arthroscopic treatment and subacromial decompression of calcific tendinitis without removal of the calcific deposit results in rapid resolution of symptoms and excellent clinical outcomes in commercial airline pilots and cabin crew
verfasst von: Erik Hohmann
Kevin Tetsworth
Publikationsdatum: 17.02.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 2/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-022-04339-y

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2023

Complications following total hip arthroplasty and hemiarthroplasty for femoral neck fractures in patients with a history of lumbar spinal fusion

Rib fractures in the elderly population: a systematic review

Two-stage shoulder arthroplasty after deep infection of the shoulder caused by arthroplasty, osteosynthesis or other surgical procedures: microbial spectrum, complications and functional outcome after at least 1 year follow-up

A clinical decision support system in back pain helps to find the diagnosis: a prospective correlation study

Posterior to anterior malleolar extended lateral approach to the ankle (PAMELA): early results of a novel approach

Injectable autologous chondrocyte implantation in acetabular cartilage defects: 2-year minimum clinical and MRI results