The intraoperative use of ultrasound facilitates significantly the arthroscopic debridement of calcific rotator cuff tendinitis.
BACKGROUND
During arthroscopy, the localization of calcific deposit in patients suffering from calcifying tendinitis can be demanding and time consuming, frequently using ionizing radiation. Intraoperative ultrasound has been recently promoted, facilitating deposit localization and reducing radiation dose.


METHODS
In this prospective, randomized, controlled and clinical observer-blinded pilot trial, 20 patients with calcific tendinitis were operated. In group I, the deposit was localized conventionally. In group II, the deposit was localized using intraoperative ultrasound. The needle punctures to detect the deposit and operation times were noted. Patients were postoperatively evaluated after 2 and 6 weeks and 9 months.


RESULTS
In group II, the needle punctures to detect the deposit were significantly lower than in group I (p < 0.0001). Operation time to localize the deposit was also significantly less in group II (p < 0.033). In both groups, patients improved significantly with increased shoulder function (p < 0.0001) and decreased pain (p < 0.0001) 2 weeks and 9 months (p < 0.001) after surgery. The difference between the groups was not significant. Excellent radiological findings were obtained in both groups after 9 months.


CONCLUSIONS
Intraoperative US significantly facilitates the detection of calcific deposits during arthroscopic debridement by speeding up surgery and reducing the number of needle punctures. Hence, we have changed our method of detecting calcific deposits intraoperatively from fluoroscopy to ultrasound.
Department for Orthopaedics and Orthopaedic Surgery, Vienna Medical School, AKH-Wien/Orthopädie, Währinger Gürtel 18-20, 1090, Vienna, Austria, manuel.sabeti@meduniwien.ac.at.
M
M
Sabeti
M
M
Schmidt
P
P
Ziai
A
A
Graf
E
E
Nemecek
C
C
Schueller-Weidekamm
D000328:Adult; D001168:Arthritis / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D002061:Bursa, Synovial / Q000601:surgery; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery; D052256:Tendinopathy / Q000150:complications / Q000473:pathology / Q000601:surgery*; D018084:Ultrasonography, Interventional