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Does intraoperative ultrasound help the surgeon in arthroscopic excision of rotator cuff tendon calcifications ?

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Arthroscopic excision of rotator cuff tendon calcifications is a common procedure in cases where medical treatment has failed. The objective of this study was to evaluate how intraoperative ultrasound contributes to improving the interventional procedure. Our hypothesis was that through the use of ultrasonography the frequency of postoperative residual calcium deposits could be reduced without increasing operating time.

Methods

In a non-randomized single-operator comparative study, 56 patients who underwent arthroscopic excision of calcification were retrospectively included: group 1 (n = 20) without ultrasound guidance and group 2 (n = 36) with guidance. Operating time was measured and localization failures noted. Radiological follow-up was carried out with x-ray images at conventional angles and ultrasound at 1.5, 3 and 6 months postoperatively. Clinical follow-up was based on the Constant score (CS) at 6 months.

Results

The mean operating time was 18 min in group 1 (9—33 ± 8.1) and 22 min in group 2 (10—48 ± 7.7) (p = 0.03). The rate of failure to identify calcifications was 8% and 2% in groups 1 and 2, respectively (p = 0.22). At 6 months, four calcifications were still visible on radiography in group 1 vs 1 in group 2 (20% vs 2.7%, p = 0.03). The mean CS increased from 35 to 81 points in group 1 (p < 0.001) and from 34 to 82 points in group 2 (p < 0.001).

Conclusion

Despite an increase in operating time, intraoperative ultrasound improves the process of excising rotator cuff intratendinous calcifications, prevents localization failures and enables a more complete extraction.

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Authors and Affiliations

  1. Groupe Orthopedie Ormeau Pyrenees-Polyclinique de l’Ormeau, 28 Bvd du 8 Mai 1945, 65000, Tarbes, France

    Vincent Martinel & Patricio Maltes Fermandois

  2. Hopital Pierre Paul Riquet-CHU de Toulouse-Place Baylac, 31059, Toulouse, France

    Nicolas Bonnevialle

  3. Institut de Recherche Riquet (I2R), Balma, France

    Nicolas Bonnevialle

Authors
  1. Vincent Martinel
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  2. Nicolas Bonnevialle
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  3. Patricio Maltes Fermandois
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Contributions

NB responsible for writing the manuscript and manuscript reviewing; VM participated in figure design and data collection; PMF involved in data collection.

Corresponding author

Correspondence to Nicolas Bonnevialle.

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Conflict of interest

The authors declare that they do not have any conflict of interest.

Ethic approval

This study was approved by the institutional ethical board (RnIPH 2019–36).

Consent to participate

Patients gave their written consent to be included and allowed the authors to use the data relative to this study.

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Each author warrants that his/her contribution to the Work is original and that he/she has participated sufficiently in the conception and design of this work, intellectual content, and the writing of the work to take responsibility for the integrity and accuracy of the data. Each author has reviewed the final version of the work, believes it represents valid and honest work and approves it for publication. Each author warrants that this Work contains no libelous or unlawful statements and does not infringe on the rights of others.

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Martinel, V., Bonnevialle, N. & Maltes Fermandois, P. Does intraoperative ultrasound help the surgeon in arthroscopic excision of rotator cuff tendon calcifications ?. Eur J Orthop Surg Traumatol 32, 939–944 (2022). https://doi.org/10.1007/s00590-021-03045-6

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  • DOI: https://doi.org/10.1007/s00590-021-03045-6

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