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Arthroscopic Treatment of Calcific Tendonitis of the Rotator Cuff

March 15, 2015

Contributors: Michael B. Ellman, MD; Peter J Millett, MD, MSc; Simon Euler, MD; Simon Euler, MD

Calcific tendonitis of the rotator cuff may be one of the most painful of all shoulder conditions. The prevalence of calcific tendonitis is 3-8%, yet only 50% of patients are symptomatic. Eighty percent of cases involve the supraspinatus tendon, 15% of cases involve the infraspinatus, and 5% the subscapularis. The majority of cases are treated conservatively with rest, activity modification, anti-inflammatories, and injections. However, when patients fail nonoperative treatment modalities, surgical treatment should be considered. When the calcium deposits are removed, the remaining rotator cuff may require repair. The accompanying video presents two cases of arthroscopic treatment of calcific tendonitis of the rotator cuff. The epidemiology, pathophysiology, and clinical findings associated with the disease process are reviewed. In addition, two examples of arthroscopic treatment tendonitis are presented. Intraoperative technical pearls include: (i) the use of a spinal needle to localize the area of calcification; (ii) copious lavage of all calcium deposits from the joint, as leaving calcium in the joint increases the risk for postoperative stiffness and adhesive capsulitis; and (iii) evaluation and proper management of resulting rotator cuff defects. When small, partial thickness defects remain following excision of all calcium deposits, treatment typically consists of simple debridement of the rotator cuff. In contrast, if a deep partial or full thickness rotator cuff tear is present, the defect should be repaired. Repair methods are demonstrated in the cases provided. Finally, an emphasis should be placed on early range of motion postoperatively to prevent stiffness, one of the most common complications following arthroscopic treatment of calcific tendonitis.

Results for "Shoulder Preservation"

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