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Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source
Published on: December 23, 2022
[Shoulder calcifying tendinitis]
1Centre de chirurgie orthopédique et de la main, avenue Baumann, 67400 Illkirch-Graffenstaden, France.
Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur
|September 12, 2009
Summary
Calcifying tendinitis, a common shoulder issue, is often temporary and doesn't necessitate rotator cuff repair after arthroscopic excision. Pre-operative rotator cuff health significantly impacts surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Diseases
- Shoulder Pathology
Background:
- Calcifying tendinitis is a frequent shoulder condition with debated surgical management.
- Rotator cuff calcifications have a prevalence of 7.3% in the general population, with female predominance.
Purpose of the Study:
- To evaluate the long-term outcomes of arthroscopic excision for calcifying tendinitis.
- To assess the prevalence of rotator cuff calcifications in asymptomatic shoulders.
- To determine the necessity of rotator cuff repair following calcific deposit removal.
Main Methods:
- Retrospective review of 450 patients treated with arthroscopic excision for calcifying tendinitis.
- Prospective study evaluating the prevalence of calcifications in 1276 asymptomatic shoulders.
- Minimum five-year follow-up for operated patients; minimum two years for subscapularis and infraspinatus calcifications.
Main Results:
- Calcifying tendinitis is a temporary condition, unrelated to rotator cuff rupture, with no observed recurrence after complete removal.
- The rate of full-thickness tears was 3.9% at an average nine-year follow-up.
- Preoperative rotator cuff status, including partial tears or positive Jobe tests, significantly influenced functional results and increased tear rates.
- Arthroscopic treatment yielded good results, though functional outcomes were lower for type C calcifications. Acromioplasty improved results in specific cases.
Conclusions:
- Rotator cuff suture after calcific deposit excision is not mandatory.
- Preoperative rotator cuff integrity is crucial for successful surgical outcomes in calcifying tendinitis.
- Arthroscopic excision is effective, but surgical approach and patient factors influence results.
