title: Smoking and morphology of calcific deposits affect the outcome of needle aspiration of calcific deposits (NACD) for calcific tendinitis of the rotator cuff.
abstract: BACKGROUND
  Although NACD has proven to be an effective minimal invasive treatment for calcific tendinitis of the rotator cuff, little is known about the factors associated with treatment failure or the need for multiple procedures.
  
  
  METHODS
  Patients with symptomatic calcific tendinitis who were treated by NACD were evaluated in a retrospective cohort study. Demographic details, medical history, sonographic and radiographic findings were collected from patient files. Failure of NACD was defined as the persistence of symptoms after a follow-up of at least six months. NACD procedures performed within six months after a previous NACD procedure were considered repeated procedures. Multivariate logistic regression analysis was used to determine factors associated with treatment failure and multiple procedures.
  
  
  RESULTS
  431 patients (277 female; mean age 51.4±9.9 years) were included. Smoking (adjusted odds ratio (AOR): 1.7, 95% CI 1.0-2.7, p=0.04) was significantly associated with failure of NACD. Patients with Gärtner and Heyer (GH) type I calcific deposits were more likely to need multiple NACD procedures (AOR: 3.4, 95% CI 1.6-7.5, p<0.01) compared to patients with type III calcific deposits. Partial thickness rotator cuff tears were of no influence on the outcome of NACD or the number of treatments necessary.
  
  
  CONCLUSIONS
  Smoking almost doubled the chance of failure of NACD and the presence of GH type I calcific deposits significantly increased the chance of multiple procedures. Partial thickness rotator cuff tears did not seem to affect the outcome of NACD. Based on the findings in this study, the importance of quitting smoking should be emphasized prior to NACD and partial thickness rotator cuff tears should not be a reason to withhold patients NACD.
authors: Centre for Orthopaedic Surgery OCON, Shoulder Unit, P.O. Box 546, 7550 AM, Hengelo, The Netherlands.
authors: Bart W
authors: BW
authors: Oudelaar
authors: Centre for Orthopaedic Surgery OCON, Shoulder Unit, P.O. Box 546, 7550 AM, Hengelo, The Netherlands.
authors: Edwin M
authors: EM
authors: Ooms
authors: Centre for Orthopaedic Surgery OCON, Shoulder Unit, P.O. Box 546, 7550 AM, Hengelo, The Netherlands.
authors: Rianne  M H A
authors: R
authors: Huis In 't Veld
authors: Department of Radiology, Department of radiology Hengelo, Ziekenhuisgroep Twente, P.O. Box 546, 7550 AM Hengelo, The Netherlands.
authors: Relinde
authors: R
authors: Schepers-Bok
authors: Centre for Orthopaedic Surgery OCON, Shoulder Unit, P.O. Box 546, 7550 AM, Hengelo, The Netherlands.
authors: Anne J
authors: AJ
authors: Vochteloo
mesh_terms: D044963:Biopsy, Fine-Needle; D002114:Calcinosis / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects*; D052256:Tendinopathy / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Calcific tendinitis; Needle aspiration of calcific deposits; Prognostic factors; Rotator cuff; Smoking