Arthroscopic treatment of non-homogeneous calcifying tendinitis of the rotator cuff

Rotator cuff debridement compared with rotator cuff repair in arthroscopic treatment of calcifying tendinitis of the shoulder: A systematic review and meta-analysis

INTRODUCTION

Although conservative treatment of calcific tendinopathy has a high success rate, arthroscopic excision of the calcific deposit is occasionally necessary. Controversy exists as to whether the remaining rotator cuff defect can be left in situ or should be repaired to achieve better functional outcomes. This study aimed to compare the results of debridement versus debridement combined with suturing in arthroscopic surgery for calcific tendinopathy.

METHODOLOGY

MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched from inception to February 2023 for articles on arthroscopic treatment of calcific tendinopathy. Functional outcomes (VAS, ASES, UCLA, and Constant) and the number of complications were analyzed. The effect size was calculated using Cohen's d-index.

RESULTS

Twenty-one studies were included, including a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The combined ES estimates for the total score of the VAS, ASES, UCLA, and Constant scales were very strong (>1.0) for both debridement and combined debridement with suture. The ES estimates for the number of total complications were 1.75 (95% CI: 0.08-3.43, I2 = 0%) for debridement and 9.07 (95% CI: -0.03-18.17, I2 = 50.4%) for combined debridement with suture.

CONCLUSIONS

Both arthroscopic procedures improve the total score significantly on the EVA, ASES, UCLA, and Constant scales. However, a higher proportion of complications was observed in the group that performed suturing. In this regard, we must consider whether it is really necessary to repair all partial tears after the calcified deposits removal.

The effect of subacromial decompression on the curative effect of arthroscopic treatment of shoulder calcific tendinitis

Objective

To observe and analyze the surgical efficacy of arthroscopic debridement of calcified deposits and arthroscopic debridement combined with subacromial decompression in patients with supraspinatus tendon calcific myositis. To observe the effect of Subacromial decompression on the efficacy of arthroscopic treatment of shoulder calcific tendinitis.

Patients and methods

From 2016 to 2021, 48 cases of shoulder arthroscopic debridement due to supraspinatus calcific tendinitis met the inclusion criteria and were included, with 24 cases assigned to the arthroscopic debridement group and 24 cases to the arthroscopic debridement combined with subacromial decompression group. Changes between preoperative and postoperative shoulder pain and shoulder function were statistically analyzed.

Results

The 24 patients in the arthroscopic debridement group were better than the arthroscopic debridement combined with subacromial decompression group in terms of short-term postoperative shoulder pain and shoulder joint function recovery (P < 0.05). There was no significant difference in the postoperative long-term shoulder pain and shoulder function recovery between the two groups (P > 0.05).

Conclusions

Compared with arthroscopic debridement combined with subacromial decompression, arthroscopic debridement alone is a better surgical option for the treatment of calcific tendinitis.

Prevalence of mineralisation of the tendon of the supraspinatus muscle in non-lame dogs

OBJECTIVES

Mineralisation of the tendon of the supraspinatus muscle has been reported as a common finding in dogs with thoracic limb lameness. It is not clear if the mineralisation is a clinically significant cause, or a secondary effect, of lameness. The aim of this retrospective study was to determine the prevalence of mineralisation of the tendon of the supraspinatus muscle in dogs presented to the clinic for reasons other than lameness and where lameness was not evident at the time of presentation.

MATERIALS AND METHODS

Dogs undergoing CT of the thorax were identified from the clinical records. The dogs selected were those presented for clinical issues other than lameness and with no history of lameness. The CT scans were screened to identify the presence or otherwise of supraspinatus mineralisation. Signalment was recorded on all the cases.

RESULTS

Supraspinatus mineralisation was detected in four out of 99 dogs (4%) with all four cases found in male dogs. Medium to large breed dogs were most frequently affected, with a mean age of 9 years. Unilateral mineralisation of the left thoracic limb only was identified.

CLINICAL SIGNIFICANCE

The prevalence of supraspinatus mineralisation was low in this population of non-lame dogs. This low level when compared to the higher prevalence level found in lame dogs, suggests that supraspinatus mineralisation could be associated with lameness in dogs either as an indirect result of lameness or as a primary cause.