ShoulderCalcific tendonitis of the shoulder: is subacromial decompression in combination with removal of the calcific deposit beneficial?
Section snippets
Materials and methods
This retrospective study included 50 consecutive patients with symptomatic calcification of the supraspinatus tendon who underwent surgical treatment in our institution between 1996 and 2006.
Imaging analysis
Calcium deposition was characterized as discrete or fragmented and dense or fluffy using the classification scheme developed by Mole et al21 (Table II). Approximately 76% of the calcifications were dense (type A or B) and 24% were fluffy (type C). The small sample size of this study did not permit a comparison of outcomes related to the pattern of calcification. Complete removal of calcium was achieved in 44 patients (88%) after surgery, with faint specks apparent in 6 (12%). Outlet view
Discussion
This study documented 2 major findings: (1) patients undergoing debridement alone of a calcific deposit of the supraspinatus tendon had earlier relief of pain and return to activity than patients undergoing combined debridement and arthroscopic subacromial decompression, and (2) no long-term differences between the 2 groups were measured. Our overall treatment outcomes compared favorably with other studies that found good to excellent results approaching 90%.2, 11, 16, 17, 27
The rationale for
Conclusion
This study found that the concomitant use of acromioplasty significantly delayed the time to return to normal activity without the benefit of any long-term improvement in patient outcome. Therefore, we concluded that subacromial decompression as an added procedure in the removal of a calcific deposit was not beneficial. We believe that debridement of a calcific deposit alone is a better surgical option to treat calcific tendonitis.
Disclaimer
The authors received no funding in support of this study.
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (35)
Chronic calcific tendonitis of the rotator cuff: a systematic review and meta-analysis of randomized controlled trials comparing operative and nonoperative interventions
2023, Journal of Shoulder and Elbow SurgeryRotator cuff debridement compared with rotator cuff repair in arthroscopic treatment of calcifying tendinitis of the shoulder: A systematic review and meta-analysis
2023, Revista Espanola de Cirugia Ortopedica y TraumatologiaRecovery pattern after arthroscopic treatment for calcific tendinitis of the shoulder
2020, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :However, Maier et al. reported that the average period required for the remission of shoulder pain was 2.24 weeks [11]. Additional acromioplasty, concomitant rotator cuff repair, duration of symptom, type of acromion, and residual calcific deposits are considered potential prognostic factors for outcomes of surgical treatment of calcific tendinitis [1,11–13]. However, it is largely unknown which factors influence postoperative clinical outcomes following surgical treatment of calcific tendinitis.
Calcifying Tendinitis of Shoulder: A Concise Review
2018, Journal of OrthopaedicsCitation Excerpt :Arthroscopy being less aggressive on tissues is associated with less surgical morbity and early recovery. There are number of studies reporting excellent results with arthroscopic excision of deposits.42–45 Ogon et al. described the negative prognostic factors that may require early surgical intervention.6
Treatment strategies in calcific tendonitis of the rotator cuff
2018, Revue du Rhumatisme MonographiesPatients with Impingement Syndrome with and Without Rotator Cuff Tears Do Well 20 Years after Arthroscopic Subacromial Decompression
2016, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Tillander et al.39 suggested that ASD itself suffices to allow free gliding under the acromion and that no removal of the calcium deposits is needed.39 Other authors see no advantage or even disadvantage for patients who receive an ASD with debridement of deposits in comparison with debridement without ASD.17,37 We suggest that as much calcium be removed as possible under intraoperative radiographic control.
The institutional review board of University of California-Davis reviewed and approved this study (IRB approval number: 200816629-1; October 13, 2008).