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Calcific tendonitis of the shoulder; when should we operate?
T Berg1, J M Bentley2, N Saravanan2
1University of Nottingham, UK.
Annals of the Royal College of Surgeons of England
|July 15, 2025
Summary
Calcific tendonitis larger than 10mm, female sex, and chronic symptoms over eight months predict surgery. Failed steroid injections also indicate a need for operative intervention in calcific tendonitis patients.
Area of Science:
- Orthopedics
- Musculoskeletal Health
Background:
- Calcific tendonitis is a common cause of shoulder pain.
- Nonoperative management is often the first line of treatment.
- Predictors of treatment failure require further investigation.
Purpose of the Study:
- To identify patient factors associated with failed nonoperative management of calcific tendonitis.
- To determine if calcific deposit size predicts the need for surgery.
Main Methods:
- Retrospective review of a prospectively maintained database (2014-2018).
- Analysis of 61 patients with calcific tendonitis.
- Data collected included deposit size/location, comorbidities, and functional scores.
Main Results:
- Factors predicting nonoperative failure: calcific deposit >10mm (p=0.009), female sex (p=0.005), chronic symptoms >8 months (p=0.001).
- Previous treatment failure (p=0.001) and ineffective steroid injections (p=0.02) also predicted surgery.
- Deposit size >10mm was associated with increased likelihood of requiring surgery.
Conclusions:
- Patients with larger calcific deposits (>10mm), female sex, or symptoms >8 months are more likely to need surgery.
- Transient responses to steroid injections or physiotherapy suggest potential need for surgical management.
- These factors aid in predicting surgical intervention for calcific tendonitis.
