Arthroscopic therapy of tendinitis calcarea--acromioplasty or removal of calcium?

Abstract

In a retrospective analysis we evaluated 48 patients who had been arthroscopically treated for tendinitis calcarea. The calcific deposit was removed whenever possible and all patients were treated by arthroscopic subacromial decompression. In subjects who showed subacromial stenosis by X-ray or by intraoperative findings, an arthroscopic acromioplasty was performed. At follow-up all patients were evaluated according to the Constant score. Additionally all pre- and postoperative X-rays were reviewed. After surgery the Constant score significantly improved. In all cases where acromioplasty was performed, a flattening of the bony configuration was achieved. The X-ray analysis showed that no calcific deposit with blurred borders converted to sharp borders. There was also no deposit that converted from a transparent appearance to a dense structure. Patients with disappearance of the calcific deposit post-operatively had significantly better outcome than patients with no change in the X-ray. An additional acromioplasty did not improve the results. The aim of arthroscopic treatment of calcific tendinitis has to be the removal of the calcific deposit. Acromioplasty does not lead to further improvement to the result.