Prospective Randomized Surgical Treatments for Calcifying Tendinopathy

Abstract

Thirty-eight patients with chronic calcifying tendinopathy of the shoulder were randomized prospectively into two groups: 19 patients had endoscopic decompression and 19 had open decompression. Thirty-three patients (19 with open and 14 with endoscopic decompression) were available for followup. Clinical and ultrasonographic investigations were done at followup. The purpose of the current study was to evaluate prospectively the clinical and sonographic results after open decompression and after endoscopic decompression. Apportionment of age and gender was similar in both groups. The followup was 15.7 months for patients after open decompression and 17.1 months for patients after endoscopic decompression. The average Patte score was 84.5 points (84.4 for patients who had endoscopic decompression and 84.6 for patients who had open decompression). Corresponding results were found with a Constant and Murley score of 96.6 points (97.6 for patients who had endoscopic decompression and 95.8 for patients who had open decompression). In the endoscopic group physiotherapy was recommended for 5 weeks more than in the open surgery group. Similar results were seen for the incapacity to work in both groups with 4.6 weeks for the patients who had endoscopic surgery and 5 weeks for the patients who had open surgery. No nerve injuries, wound infections, or other postoperative complications were found. Comparison of both surgical methods showed good clinical and score results. Endoscopic and open surgery are equally effective in the treatment of chronic calcifying tendinopathy.

Calcifying tendinitis of the shoulder: Advances in imaging and management

“…Other studies have advocated the surgical removal of deposits, either by an open or arthroscopic procedure. A subacromial decompression is only performed when there are signs of subacromial irritation [24,[35][36][37][38][39]. Tillander and Norlin [41], however, compared two groups with an impingement syndrome, one group showing deposits in the rotator cuff and the other not showing such deposits.…”

“…Most studies on surgical treatment discuss calcifi cation removal with a subacromial decompression only when there are signs of subacromial irritation [10,24,[35][36][37][38][39]. Other studies, however, advocate subacromial decompression alone, with the hope that calcifi cations will dissolve [40,41].…”

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

“…Arthroscopic or open débridement of chronic calcific tendonitis also appears a good option if patients fail nonoperative treatment [146,156,195]. Improvement in pain with a decrease in residual calcium deposits has been demonstrated after surgery compared with a matched cohort of patients treated nonoperatively [195].…”

The Effectiveness of High-Energy Extracorporeal Shockwave Therapy Versus Ultrasound-Guided Needling Versus Arthroscopic Surgery in the Management of Chronic Calcific Rotator Cuff Tendinopathy: A Systematic Review

“…4 Surgical management options include arthroscopic procedures to remove the calcified deposit and to perform subacromial decompression. [11][12][13][14][15] These procedures have been shown to have a high chance of success in restoring shoulder function and reducing pain. Controversies exist, however, regarding the extent of calcification removal, the long-term impact on the rotator cuff tendons, and the use of subacromial decompression.…”