Value of preoperative ultrasound marking of calcium deposits in patients who require surgical treatment of calcific tendinitis of the shoulder.
OBJECTIVE
The objective of our study was to evaluate whether preoperative ultrasound-guided marking of calcium deposits has a positive effect on the efficiency and speed of localization of calcium deposits during surgery, and whether this technique is a factor that increases the probability of good clinical results.


METHODS
Twenty-four patients who required surgery for calcific tendinitis in the years 2001 and 2002 were divided into 2 groups of 12 patients by week. Before undergoing surgery, those in group 1 (weeks 1, 3, 5, etc.) were given a standard ultrasound examination, along with preoperative ultrasound-guided marking (pre-USM) of calcium deposits, whereas group 2 (weeks 2, 4, 6, etc.) received the standard ultrasound examination without pre-USM. In both groups, arthroscopic removal of calcium deposits was carried out and the postoperative treatment plan was identical. The clinical result was evaluated by the Constant-Murley score.


RESULTS
At the 6-week and 2-year follow-up visits, the clinical result was significantly better (P < .05) in the pre-USM group than in the unmarked group (Constant score of 76 v 70 points and 80 v 74 points, respectively). After 12 weeks, the clinical outcomes of both groups showed an approaching significance, with better results seen in the pre-USM group (79 v 74 points; P = .052). The time required for intraoperative localization of calcium deposits was 16 versus 22 minutes. The difference showed an approaching significance (P = .057). Removal of calcium was possible in 12 versus 10 cases; complete removal was possible in 8 versus 6 cases, respectively. However, none of these variables had a statistically significant influence on our results.


CONCLUSIONS
Preoperative ultrasound-guided marking of calcific deposits is a procedure that statistically significantly improves the clinical results of arthroscopic surgery as seen at 6 weeks and 2 years; statistical significance of .052 was approached only at 12 weeks, as we have shown here for calcifying tendinitis of the shoulder joint.


METHODS
Level III, development of diagnostic criteria with nonconsecutive patients.
Kayser
Ralph
R
Klinik fur Unfall- und Wiederherstellungschirurgie, Campus Benjamin Franklin, Zentrum fur spezielle Chirurgie des Bewegungsapparates, Berlin, Germany. ralph.kayser@charite.de
Hampf
Steffen
S
Seeber
Engelbert
E
Heyde
Christoph E
CE
D000328:Adult; D001182:Arthroscopy / Q000379:methods; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011300:Preoperative Care; D017006:Rotator Cuff / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000601:surgery*; D014463:Ultrasonography