title: Arthroscopic Removal of Chronic Symptomatic Calcifications of the Supraspinatus Tendon Without Acromioplasty: Analysis of Postoperative Recovery and Outcome Factors.
abstract: BACKGROUND
  Little knowledge exists on postoperative recovery of pain and shoulder function following arthroscopic removal of calcific deposits of the supraspinatus tendon (ACDSSP). Certain factors may influence outcome, including acromial morphology.
  
  
  OBJECTIVE
  To examine postoperative recovery following ACDSSP without acromioplasty and to analyze influential outcome factors.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  This prospective study evaluated 82 patients (105 shoulders) after ACDSSP without acromioplasty. Time periods for postoperative recovery of pain and subjective shoulder function were recorded. The absolute and normalized Constant scores (CSabs and CSnorm, respectively), Oxford Shoulder Score (OSS), DASH score (DS), and subjective shoulder value (SSV) were measured after a mean follow-up of 33.9 months. Analyzed outcome factors included localization of the calcific deposit (CD), acromial morphology, radiographic extent of CD removal, type of nonoperative treatment, and preoperative duration of symptoms.
  
  
  RESULTS
  Mean duration of postoperative pain was 2.2 weeks. Recovery of subjective shoulder function required 11.1 weeks on average. Mean ± standard deviation follow-up values were 91.1 ± 8.3 for CSabs, 104.2% ± 8.2% for CSnorm, 13.1 ± 2.6 for OSS, 1.81 ± 4.59 for DS, and 93.8% ± 10.7% for SSV. Abduction was significantly (P = .008) lower in patients with type III (170° ± 17.5°) compared with type I (174° ± 20.7°) and type II (179° ± 4.5°) acromions. Also, abduction was significantly (P = .001) lower in patients with long-standing symptoms (>72 months). Minor calcific remnants were found in 19 of 105 shoulders (18.1%), but affected neither postoperative recovery nor outcome.
  
  
  CONCLUSIONS
  ACDSSP without acromioplasty yielded favorable outcomes and effected fast remission of pain regardless of acromial morphology. However, recovery of subjective shoulder function required almost 3 months on average. Minimal restriction of abduction occurred in patients with hook-shaped acromions and long-standing preoperative symptoms. The present data do not support routine performance of acromioplasty.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Maier
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Jaeger
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Kaywan
authors.initials: K
authors.lastname: Izadpanah
authors.affiliation: Department of Trauma Surgery, Hospital of Vöcklabruck, Vöcklabruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Köstler
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Bischofberger
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp
authors.affiliation: Center of Orthopaedic Sports Medicine Freiburg, Freiburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ogon
keywords: acromioplasty; calcific tendinitis; outcome factors; postoperative recovery; shoulder arthroscopy