Arthroscopic treatment of calcifying tendinitis of the supraspinatus

Abstract

Objective To investigate the pathological features and clinical outcomes of the arthroscopic treatment for calcifying tendinitis of the supraspinatus. Methods From March 2009 to October 2010,34 patients with calcifying tendinitis of the supraspinatus were treated with shoulder arthroscopy. Based on size of calcifying deposits, they were divided into three groups: small (＜10 mm), middle (≥ 10 mm, ≤20mm), and large (＞20 mm). All patients underwent arthroscopic calcium excision and subacromial decompression, and acromioplasty of shoulder was performed in 8 cases, rotator cuff neoplasty in 10. The preoperative and postoperative clinical data such as Constant's score, Visual Analog Scale (VAS) pain score and radiographs were adopted for evaluation. Besides, histological and scanning electronic microscopic examinations of calcium deposits were also carried out. Results All patients were follwed up for average 11.5 months.The patients were regularly examined at a time point of 1 month preoperatively, 2 days preoperatively and of the latest follow-up. The average Constant score was 36.1 ±6.9, 55.6±12.4 and 89.7±2.7 respectively; the average VAS pain score was 8.2±0.8,7.03±0.7,1.7±0.3 respectively. Both scoring systems revealed a significant difference before and after surgery. However, the clinical outcomes of the calcified deposit (small, middle, and large) showed on significant difference among the 3 groups. Collagen fibers were not degenerated around the calcified deposit, and no apoptotic or dead cells could be found, therefore, it is not a pathological calcification. Conclusion Recognition of calcifying tendinitis and good timing of surgery are keys to good clinical results. Shoulder arthroscopy is a safe, effective and minimally invasive method for the treatment of calcifying tendinitis of the supraspinatus. The patients with various size of the calcium deposit treated with shoulder arthroscopy can lead to an excellent clinical outcome postoperatively. Key words: Shoulder joint; Tendinopathy; Calcinosis; Arthroscopy