Arthroscopic Management of Rotator Cuff Calcific Tendonitis

  • M. Ned Scott
  • Christopher C. Schmidt
  • Brandon Brown
  • Thomas Kotsonis


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.


Rotator cuff tear Calcific tendonitis Arthroscopy Case study 


  1. 1.
    Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. J Am Acad Orthop Surg. 1997;5:183–91.CrossRefPubMedGoogle Scholar
  2. 2.
    Greis AC, Derrington SM, Mcauliffe M. Evaluation and nonsurgical management of rotator cuff calcific tendinopathy. Orthop Clin North Am. 2015;46:293–302.CrossRefPubMedGoogle Scholar
  3. 3.
    Gatt DL, Charalambous CP. Ultrasound-guided barbotage for calcific tendonitis of the shoulder: a systematic review including 908 patients. Arthroscopy. 2014;30:1166–72.CrossRefPubMedGoogle Scholar
  4. 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
  5. 5.
    Kim YS, Lee HJ, Kim YV, Kong CG. Which method is more effective in treatment of calcific tendinitis in the shoulder? Prospective randomized comparison between ultrasound-guided needling and extracorporeal shock wave therapy. J Shoulder Elb Surg. 2014;23:1640–6.CrossRefGoogle Scholar
  6. 6.
    Rompe JD, Zoellner J, Nafe B. Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orthop Relat Res. 2001;387:72–82.CrossRefGoogle Scholar
  7. 7.
    Hackett L, Millar NL, Lam P, Murrell GA. Are the symptoms of calcific tendinitis due to neoinnervation and/or neovascularization? J Bone Joint Surg Am. 2016;98:186–92.CrossRefPubMedGoogle Scholar
  8. 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. 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. 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
  11. 11.
    Seil R, Litzenburger H, Kohn D, Rupp S. Arthroscopic treatment of chronically painful calcifying tendinitis of the supraspinatus tendon. Arthroscopy. 2006;22:521–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Jarrett CD, Schmidt CC. Arthroscopic treatment of rotator cuff disease. J Hand Surg Am. 2011;36:1541–52. quiz 1552CrossRefPubMedGoogle Scholar
  13. 13.
    Bosworth BM. Calcium deposits in the shoulder and subacromial bursitis. JAMA. 1941;116:2477–88.CrossRefGoogle Scholar
  14. 14.
    Speed CA, Hazleman BL. Calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1582–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Tillander BM, Norlin RO. Changes of calcifications after arthroscopic subacromial decompression. J Shoulder Elb Surg. 1998;7:213–7.CrossRefGoogle Scholar
  16. 16.
    Porcellini G, Paladini P, Campi F, Paganelli M. Arthroscopic treatment of calcifying tendinitis of the shoulder: clinical and ultrasonographic follow-up findings at two to five years. J Shoulder Elb Surg. 2004;13:503–8.CrossRefGoogle Scholar
  17. 17.
    Le Goff B, Berthelot JM, Guillot P, Glemarec J, Maugars Y. Assessment of calcific tendonitis of rotator cuff by ultrasonography: comparison between symptomatic and asymptomatic shoulders. Joint Bone Spine. 2010;77:258–63.CrossRefPubMedGoogle Scholar
  18. 18.
    Balke M, Bielefeld R, Schmidt C, Dedy N, Liem D. Calcifying tendinitis of the shoulder: midterm results after arthroscopic treatment. Am J Sports Med. 2012;40:657–61.CrossRefPubMedGoogle Scholar
  19. 19.
    El Shewy MT. Arthroscopic removal of calcium deposits of the rotator cuff: a 7-year follow-up. Am J Sports Med. 2011;39:1302–5.CrossRefPubMedGoogle Scholar
  20. 20.
    Maier D, Jaeger M, Izadpanah K, Bornebusch L, Suedkamp NP, Ogon P. Rotator cuff preservation in arthroscopic treatment of calcific tendinitis. Arthroscopy. 2013;29:824–31.CrossRefPubMedGoogle Scholar
  21. 21.
    Yoo JC, Park WH, Koh KH, Kim SM. Arthroscopic treatment of chronic calcific tendinitis with complete removal and rotator cuff tendon repair. Knee Surg Sports Traumatol Arthrosc. 2010;18:1694–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Hofstee DJ, Gosens T, Bonnet M, De Waal Malefijt J. Calcifications in the cuff: take it or leave it? Br J Sports Med. 2007;41:832–5.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Neer CS, Marberry TA. Calcium deposits: shoulder reconstruction. Philadelphia: Saunders; 1990.Google Scholar
  24. 24.
    Verhaegen F, Brys P, Debeer P. Rotator cuff healing after needling of a calcific deposit using platelet-rich plasma augmentation: a randomized, prospective clinical trial. J Shoulder Elb Surg. 2016;25:169–73.CrossRefGoogle Scholar
  25. 25.
    Keener JD, Galatz LM, Teefey SA, Middleton WD, Steger-May K, Stobbs-Cucchi G, Patton R, Yamaguchi K. A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears. J Bone Joint Surg Am. 2015;97:89–98.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Marder RA, Heiden EA, Kim S. Calcific tendonitis of the shoulder: is subacromial decompression in combination with removal of the calcific deposit beneficial? J Shoulder Elb Surg. 2011;20:955–60.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • M. Ned Scott
    • 1
  • Christopher C. Schmidt
    • 2
  • Brandon Brown
    • 3
  • Thomas Kotsonis
    • 4
  1. 1.Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of BioengineeringUniversity of PittsburghPittsburghUSA
  4. 4.Department of Mechanical EngineeringUniversity of PittsburghPittsburghUSA

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