title: Calcifying tendinitis of the shoulder: midterm results after arthroscopic treatment.
abstract: BACKGROUND
  Calcifying tendinitis is a common and painful disorder of the shoulder characterized by the presence of calcific deposits in the tendons of the rotator cuff. When nonoperative treatment over a prolonged period of time fails, surgical treatment should be considered. Midterm success rates are inconsistent, and the role of subacromial decompression is still unclear.
  
  
  OBJECTIVE
  Our hypotheses were that the rate of supraspinatus tears after arthroscopic treatment of calcifying tendinitis is comparable with that in the contralateral uninvolved shoulder and that subacromial decompression does not have beneficial effects compared with calcium removal alone.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  In 70 shoulders of 62 patients with a mean age of 54 years, arthroscopic removal of calcium deposits of the supraspinatus tendon was performed. In 44 shoulders, additional subacromial decompression was performed. After a mean follow-up of 6 years (range, 2-13 years), patients were clinically investigated, and function was statistically evaluated using Constant and American Shoulder and Elbow Surgeons (ASES) scores. Affected and contralateral shoulders were examined by ultrasound in 48 shoulders, and rotator cuff tears were documented.
  
  
  RESULTS
  The mean Constant scores of the operated shoulders were significantly lower than those of the healthy shoulders (P < .001). The ASES scores significantly (P < .001) increased after surgery but were still lower than the ASES scores of the healthy shoulders (P < .001). Concerning the additional subacromial decompression, there were no significant differences in the overall ASES and Constant scores; the subitem "pain" was significantly better in the subacromial decompression group (P = .048). Ultrasound examination at last follow-up (48 shoulders) showed a partial supraspinatus tendon tear in 11 operated and 3 contralateral shoulders.
  
  
  CONCLUSIONS
  Although the good clinical results after arthroscopic treatment of calcifying tendinitis of the shoulder persist midterm, the affected shoulders present significantly lower clinical scores than healthy shoulders. The rate of partial supraspinatus tendon tears seems to be higher after calcium removal. Additional subacromial decompression seems to reduce postoperative pain.
authors.affiliation: Department of Orthopedic Surgery, University of Muenster, Muenster, Germany. maurice.balke@gmail.com
authors.forename: Maurice
authors.initials: M
authors.lastname: Balke
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bielefeld
authors.forename: Carolin
authors.initials: C
authors.lastname: Schmidt
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dedy
authors.forename: Dennis
authors.initials: D
authors.lastname: Liem
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011859:Radiography; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery; D012782:Shoulder / Q000000981:diagnostic imaging / Q000601:surgery*; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography