Arthroscopic Management of Rotator Cuff Calcific Tendonitis
Calcific tendonitis of the rotator cuff is a common cause of shoulder pain and loss of function. When conservative care fails to control pain and restore movement and strength, arthroscopic management is a reliable treatment. The goal of the procedure is removal of the calcific deposit without injury to the intact rotator cuff tendon. Arthroscopic needling, blunt expressing of soft deposits, and limited shaving of firm calcific deposits are the preferred techniques. Complete radiographic removal of the entire calcific deposits is not necessary. High-grade (>50%) partial and complete tears of the rotator cuff created during deposit removal should be repaired by techniques that preserve the intact tendon. Low-grade (<50% of the tendon thickness) partial tears can simply be debrided. Arthroscopic subacromial decompression is performed if impingement signs are present. Significant clinical relief of symptoms can take up to 6–12 months and while it may never be complete radiographic absorption of the deposit can take up to a year.
KeywordsRotator cuff tear Calcific tendonitis Arthroscopy Case study
- 4.Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wortler K, Lampe R, Seil R, Handle G, Gassel S, Rompe JD. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003;290:2573–80.CrossRefPubMedGoogle Scholar
- 8.Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis: a new concept of its pathogenesis. Clin Orthop Relat Res. 1976;118:164–8.Google Scholar
- 9.Louwerens JK, Sierevelt IN, Van Hove RP, Van Den Bekerom MP, Van Noort A. Prevalence of calcific deposits within the rotator cuff tendons in adults with and without subacromial pain syndrome: clinical and radiologic analysis of 1219 patients. J Shoulder Elb Surg. 2015;24:1588–93.CrossRefGoogle Scholar
- 10.Arrigoni P, Brady PC, Burkhart SS. Calcific tendonitis of the subscapularis tendon causing subcoracoid stenosis and coracoid impingement. Arthroscopy. 2006;22(1139):e1–3.Google Scholar
- 23.Neer CS, Marberry TA. Calcium deposits: shoulder reconstruction. Philadelphia: Saunders; 1990.Google Scholar