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Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of the present study is the evaluation of a possible influence of the preoperative deposit stage, the postoperative deposit elimination and failed preoperative extracorporeal shockwave therapy on the surgical outcome of arthroscopic treatment of tendinosis calcarea. From 1997 to 2004, 65 patients underwent arthroscopic resection of calcific deposits of the shoulder after failed conservative treatment. Patients with rotator cuff tears, major cartilage damage, or previous surgery were excluded. Out of 50 patients 45 (17 men, 28 women) that could be contacted with a mean age of 49 ± 8 years could be followed-up with a mean of 36 months (14–89) after surgery. A total of 24 patients (53.3%) underwent preoperative extracorporeal shock-wave therapy (ESWT). For the clinical evaluation the Constant and Murley Score, the Simple Shoulder Test, the Western Ontario Rotator Cuff Index (WORC) and visual analog scales for pain, function and satisfaction were used. For the radiological evaluation, the classifications according to Gaertner and Bosworth were used. Statistical analysis was done with the Wilcoxon test, the Mann–Whitney test and ANOVA. The Constant and Murley Score improved significantly from preoperative 63.5 ± 11.4 to postoperative 93.9 ± 9.9 points (P < .0001) at follow-up, the Simple Shoulder Test from 1.7 ± 2 to 9.9 ± 2.8 points (P < .0001), the WORC score from 1,591.2 ± 337.4 to 345.4 ± 392 points (P < .0001). The visual analog scales for pain, function and patient satisfaction also significantly improved (P < .0001). Preoperative radiological evaluation according to the Gaertner classification revealed 37 type I deposits, 6 type II and 2 type III deposits; postoperative no calcific deposits were seen in 37 patients, 6 type I and 2 type III deposits. According to the Bosworth classification 13 type I, 19 type II and 13 type III deposits were seen preoperatively. Postoperative X-rays showed 6 type I and 1 type II and III deposits. There was no significant correlation of the clinical results with the pre- or postoperative findings. The 24 patients who underwent ESWT before surgery did not show significantly better results than patients without ESWT. In conclusion, arthroscopic removal of calcific deposits of the shoulder shows good clinical results for pain reduction, shoulder function and patient satisfaction. The type of calcific deposit and the preoperative treatment of the shoulder with ESWT did not have any significant impact on the postoperative results.

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References

  1. Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, Chales G (2007) High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg Br 89:335–341

    Article  PubMed  Google Scholar 

  2. Ark JW, Flock TJ, Flatow EL, Bigliani LU (1992) Arthroscopic treatment of calcific tendinitis of the shoulder. Arthroscopy 8:183–188

    Article  PubMed  CAS  Google Scholar 

  3. Beaton D, Richards RR (1998) Assessing the reliability and responsiveness of 5 shoulder questionnaires. J Shoulder Elbow Surg 7:565–572

    Article  PubMed  CAS  Google Scholar 

  4. Bosworth BM (1941) Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA 116:2477–2482

    Google Scholar 

  5. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  6. Farin PU (1996) Consistency of rotator-cuff calcifications. Observations on plain radiography, sonography, computed tomography, and at needle treatment. Invest Radiol 31:300–304

    Article  PubMed  CAS  Google Scholar 

  7. Gaertner J, Heyer A (1995) Calcific tendinitis of the shoulder. Orthopade 24:284–302

    Google Scholar 

  8. Gaertner J, Simons B (1990) Analysis of calcific deposits in calcifying tendinitis. Clin Orthop Relat Res 254:111–120

    Google Scholar 

  9. Gazielly DF, Bruyere G, Gleyze P, Thomas T (1997) Open acromioplasty with excision of calium deposits and tendon suture. In: Gazielly D, Gleyze P, Thomas T (eds) The cuff. Elsevier, Paris

    Google Scholar 

  10. Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wortler K, Lampe R, Seil R, Handle G, Gassel S, Rompe JD (2003) Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA 290:2573–2580

    Article  PubMed  CAS  Google Scholar 

  11. Hartig A, Huth F (1995) Neue Aspekte zur Morphologie und Therapie der Tendonosis calcarea der Schultergelenke. Arthroskopie 8:117–121

    Google Scholar 

  12. Jerosch J, Strauss JM, Schmiel S (1996) Arthroskopische Therapie der Tendinitis calcarea. Wie wichtig ist die Kalkdepotentfernung? Arthroskopie 9:241–245

    Google Scholar 

  13. Jerosch J, Strauss JM, Schmiel S (1998) Arthroscopic treatment of calcific tendinitis of the shoulder. J Shoulder Elbow Surg 7:30–37

    Article  PubMed  CAS  Google Scholar 

  14. Kempf JF, Bonnomet F, Nerisson D, Gastaud F, Lacaze F, Geraud H (1997) Arthroscopic isolated excision of rotator cuff calcium deposits. In: Gazielly DF, Gleyze P, Thomas T (eds) The cuff. Elsevier, Paris, pp 164–167

    Google Scholar 

  15. Kirkley A, Griffin S, Dainty K (2003) Scoring systems for the functional assessment of the shoulder. Arthroscopy 19:1109–1120

    Article  PubMed  Google Scholar 

  16. Krasny C, Enenkel M, Aigner N, Wlk M, Landsiedl F (2005) Ultrasound-guided needling combined with shock-wave therapy for the treatment of calcifying tendonitis of the shoulder. J Bone Joint Surg Br 87:501–507

    Article  PubMed  CAS  Google Scholar 

  17. Loew M, Jurgowski W, Mau HC, Thomsen M (1995) Treatment of calcifying tendinitis of rotator cuff by extracorporeal shock waves: a preliminary report. J Shoulder Elbow Surg 4:101–106

    Article  PubMed  CAS  Google Scholar 

  18. Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V (1999) Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder. J Bone Joint Surg Br 81:863–867

    Article  PubMed  CAS  Google Scholar 

  19. Mole D, Kempf JF, Gleyze P, Rio B, Bonnomet F, Walch G (1993) Results of endoscopic treatment of non-broken tendinopathies of the rotator cuff. 2. Calcifications of the rotator cuff. Rev Chir Orthop Reparatrice Appar Mot 79:532–541

    PubMed  CAS  Google Scholar 

  20. Moretti B, Garofalo R, Genco S, Patella V, Mouhsine E (2005) Medium-energy shock wave therapy in the treatment of rotator cuff calcifying tendinitis. Knee Surg Sports Traumatol Arthrosc 13:405–410

    Article  PubMed  Google Scholar 

  21. Porcellini G, Paladini P, Campi F, Paganelli M (2004) Arthroscopic treatment of calcifying tendinitis of the shoulder: clinical and ultrasonographic follow-up findings at two to five years. J Shoulder Elbow Surg 13:503–508

    Article  PubMed  Google Scholar 

  22. Rompe JD, Zollner J, Nafe B, Freitag C (2000) Significance of calcium deposit elimination in tendinosis calcarea of the shoulder. Z Orthop Ihre Grenzgeb 138:335–339

    Article  PubMed  CAS  Google Scholar 

  23. Rompe JD, Zoellner J, Nafe B (2001) Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orthop Relat Res 387:72–82

    Article  PubMed  Google Scholar 

  24. Rupp S, Seil R (2003) Tendinosis calcarea der Rotatorenmanschette. Arthroskopie 3:185–201

    Article  Google Scholar 

  25. Rupp S, Seil R, Kohn D (2000) Tendinosis calcarea of the rotator cuff. Orthopade 29:852–867

    Article  CAS  Google Scholar 

  26. Seil R, Rupp S, Hammer DS, Ensslin S, Gebhardt T, Kohn D (1999) Extracorporeal shockwave therapy in tendionosis calcarea of the rotator cuff: comparison of different treatment protocols. Z Orthop Ihre Grenzgeb 137:310–315

    Article  PubMed  CAS  Google Scholar 

  27. Seil R, Litzenburger H, Kohn D, Rupp S (2006) Arthroscopic treatment of chronically painful calcifying tendinitis of the supraspinatus tendon. Arthroscopy 22:521–527

    Article  PubMed  Google Scholar 

  28. Siebold R, Jung D, Lichtenberg S, Habermeyer P (2003) Arthroskopische Kalkexstirpation bei Tendinosis calcarea. Welchen Vorteil hat eine zusätzliche intraoperative Bildwandlerkontrolle? Arthroskopie 3:209–214

    Article  Google Scholar 

  29. Spindler A, Berman A, Lucero E, Braier M (1998) Extracorporeal shock wave treatment for chronic calcific tendinitis of the shoulder. J Rheumatol 25:1161–1163

    PubMed  CAS  Google Scholar 

  30. Tillander BM, Norlin RO (1998) Change of calcifications after arthroscopic subacromial decompression. J Shoulder Elbow Surg 7:213–217

    Article  PubMed  CAS  Google Scholar 

  31. Uhthoff HK, Sarkar K (1989) Calcifying tendinitis. Baillieres Clin Rheumatol 3:567–581

    Article  PubMed  CAS  Google Scholar 

  32. Wang CJ, Ko JY, Chen HS (2001) Treatment of calcifying tendinitis of the shoulder with shock wave therapy. Clin Orthop Relat Res 387:83–89

    Article  PubMed  Google Scholar 

  33. Wang CJ, Yang KD, Wang FS, Chen HH, Wang JW (2003) Shock wave therapy for calcific tendinitis of the shoulder: a prospective clinical study with two-year follow-up. Am J Sports Med 31:425–430

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Saarland University, Kirrberger Strasse, 66421, Homburg/Saar, Germany

    O. Lorbach, M. Kusma, D. Pape, D. Kohn & M. Dienst

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  1. O. Lorbach
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  2. M. Kusma
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  3. D. Pape
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  4. D. Kohn
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Lorbach, O., Kusma, M., Pape, D. et al. Influence of deposit stage and failed ESWT on the surgical results of arthroscopic treatment of calcifying tendonitis of the shoulder. Knee Surg Sports Traumatol Arthr 16, 516–521 (2008). https://doi.org/10.1007/s00167-008-0507-0

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