Arthroscopic treatment of calcific tendonitis of the shoulder: clinical and ultrasonographic follow-up findings at 2 to 5 years

Authors: Porcellini et al.

References: Presented at AAOS 2003

Abstract
Introduction: To evaluate the clinical outcome and ultrasound findings of calcifying tendinitis of the shoulder in patients treated by arthroscopic removal of the calcium deposits and to relate this outcome to the presence of residual calcifications in the tendon. Material & Methods: From 1996 to 1999, 95 shoulders with calcifying tendinitis were treated arthroscopically; 63 patients (66.3%) were included in the study. Preoperative radiographic and ultrasound investigations identified the site, size and appearance of calcifications. We removed all the calcium detected, leaving the minor tendon tears (less than 10 mm) unsutured and suturing the longer partial tears and all complete tears. Clinical and ultrasound examination was performed at least at 2 years to detect the final Constant's outcome score and the presence and size of residual calcium deposits. We correlate the presence of postoperative calcium deposits to the preoperative ultrasound findings and follow-up Constant's scores using a statistical tool. Results: The mean Constant's score rose from 55.1/100 ± 12.31 (range: 31.6-73.3) preoperatively to 86.4/100 ± 7.2 (range 63-100) postoperatively. The postoperative ultrasound findings showed: absence of calcifications in 13 patients (20.6%), micro-calcifications (1-2 mm) in 45 (71.4%), and calcifications less than 10 mm in 5 patients (8%), and no cuff tears. Discussion and Conclusion: The main findings of the present study suggest that size, shape and location of calcium deposit, acromioplasty, and suturing of the residual cuff tear did not affect Constant's outcome score. By contrast, presence of residual calcium deposits consistently resulted in a lower Constant's outcome scores.