Arthroscopic treatment of chronically painful calcifying tendinitis of the supraspinatus tendon.
OBJECTIVE
The purpose of this study was to analyze the outcome of arthroscopic removal of calcifying tendinitis of the rotator cuff, to document the postoperative pain evolution, and to analyze structural changes of the supraspinatus tendon by use of ultrasonography.


METHODS
Fifty-four of 58 patients with a mean age of 45.4 years (+/-8 years) enrolled in the study were available for follow-up. The calcific deposits were exclusively located in the supraspinatus tendon. Shoulder function was evaluated by using the Constant score. Radiographs were obtained preoperatively, immediately postoperatively, and at 3, 6, 12, and 24 months. The integrity of the rotator cuff was assessed by using ultrasonography.


RESULTS
Shoulder function according to the Constant score improved from 32.8 points (+/-19.8) preoperatively to 90.9 (+/-13.0) at 24 months (P < 0.001). The evolution of postoperative pain was very irregular; 31% of the patients were pain free or reached their minimum pain level after 3 months, 17% after 6 months, 20% after 9 months, and 28% after 12 months; 78% of the patients returned to work within 6 weeks, irrespective of their profession. At the final follow-up 92% of the patients were very satisfied with the outcome. Ultrasonography revealed minor structural changes of the supraspinatus tendon in 66% of the patients.


CONCLUSIONS
The study confirmed previously reported successful results of arthroscopic treatment of calcifying tendinitis of the rotator cuff. Complete intraoperative removal of the deposit did not appear to be essential. Even if most of the patients were able to return to work within 6 weeks, postoperative recovery was prolonged over several months in most of the patients. The clinical relevance of the ultrasonographic changes of the supraspinatus tendon has not yet been determined.


METHODS
Level IV, therapeutic case series.
Seil
Romain
R
Department of Orthopaedic Surgery, University of Saarland Medical School, Homburg/Saar, Germany. rseil@yahoo.com
Litzenburger
Heike
H
Kohn
Dieter
D
Rupp
Stefan
S
D000203:Activities of Daily Living; D000328:Adult; D001182:Arthroscopy; D002114:Calcinosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology; D052256:Tendinopathy / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography; D014938:Work Capacity Evaluation