Preoperative ultrasonographic-guided marking of calcium deposits in the rotator cuff facilitates localization during arthroscopic surgery

Sørensen, Lilli; Teichert, Gerhardt; Skjødt, Thomas; Dichmann, Ole

doi:10.1016/j.arthro.2004.04.024

Cited by 19 publications

(13 citation statements)

References 4 publications

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“…Surgical débridement of homogeneous calcium deposits in the supraspinatus appeared more reliable than ESWT in a randomized, controlled trial [144]. This treatment can be facilitated by marking the calcific deposits preoperatively using ultrasound guidance [82,162].…”

Section: Surgerymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

441

345

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Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.

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Section: Surgerymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

441

345

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“…Calcific rotator cuff tendiniopathy accounts for 7%-20% of all painful shoulders and results from symptomatic calcium hydroxyapatite crystal deposition into one or more rotator cuff tendons [1][2][3]. The supraspinatus tendon is most commonly affected, but involvement of the infraspinatus and subscapularis tendons is well documented [4][5][6][7][8][9][10][11][12][13]. Calcific rotator cuff tendinopathy most commonly affects individuals between 30 and 50 years of age, with a slight female predilection [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Although the precise etiology of calcific hydroxyapatite deposition has not been determined, proposed theories to explain this condition include ischemia/hypoxia, metabolic disturbances caused by endocrine disorders, localized pressure/microtrauma, and fibrocartilaginous transformation of degenerative tendon tissue [17‐21]. On the contrary, it is generally agreed that the sonographic appearance of calcific rotator cuff tendinitis can vary over time and roughly correlates with the presence of symptoms [6,11,12]. Well‐defined, dense, hyperechoic calcifications with posterior acoustic shadowing appear to represent a formative phase.…”

Section: Introductionmentioning

confidence: 99%

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A Simple Technique to Restore Needle Patency During Percutaneous Lavage and Aspiration of Calcific Rotator Cuff Tendinopathy

Jelsing¹,

Maida²,

Smith³

2013

PM&R

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Calcific rotator cuff tendinopathy caused by symptomatic calcium hydroxyapatite crystal deposition is a well-established cause of shoulder pain. In refractory or acutely symptomatic cases, sonographically guided percutaneous lavage and aspiration can significantly reduce pain in approximately 60%-92% of cases. Although the complication rate of sonographically guided percutaneous lavage and aspiration is apparently low, needle clogging attributable to impacted calcific debris has been described by several authors and in our experience can occur in daily practice. Traditionally, an inability to relieve the obstruction via needle repositioning or increased syringe plunger pressure has required needle removal and replacement. In this article, we outline a simple technique that can be used to restore patency of the obstructed lavage needle without necessitating needle removal and replacement.

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“…It has been used in several arthroscopic techniques for shoulder, hip, foot, and carpal tunnel. 14 , 15 , 16 , 17 …”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Assisted Posteromedial Portal Placement of the Elbow Joint to Prevent Ulnar Nerve Injury

Ohuchi

Torres

Shinga

et al. 2017

Arthroscopy Techniques

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Direct posterior and posterolateral portals are the standard portals used in posterior elbow arthroscopy. A posteromedial portal in the elbow is not recommended because of its proximity to the ulnar nerve. However, iatrogenic injuries to the ulnar nerve have been reported after elbow arthroscopy using the standard posterior portals, especially in posteromedial elbow joint pathologies. We present a surgical technique applicable to posteromedial elbow pathology by using ultrasound-assisted posteromedial portal placement of the elbow joint. Through this technique, the position of the ulnar nerve is identified prior to portal creation and the instruments are introduced from an ulnar to radial direction, thus avoiding ulnar nerve injury.

show abstract

Preoperative ultrasonographic-guided marking of calcium deposits in the rotator cuff facilitates localization during arthroscopic surgery

Cited by 19 publications

References 4 publications

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

A Simple Technique to Restore Needle Patency During Percutaneous Lavage and Aspiration of Calcific Rotator Cuff Tendinopathy

Ultrasound-Assisted Posteromedial Portal Placement of the Elbow Joint to Prevent Ulnar Nerve Injury

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