Could intraoperative ultrasound improve clinical and radiological outcomes during arthroscopic calcification evacuation of rotator cuff?

Abstract

IntroductionMartinel et al described an intraoperative ultrasound technique to easier identify calcification under arthroscopy. Our hypothesis was that intra-operative ultrasound monitoring allowed better evacuation of calcific tendinitis (CT). Our aim was to determine whether ultrasound monitoring improved the short-term clinical and radiological outcomes of CT. MethodsA prospective, single-center, single-operator, consecutive study conducted between February 2020 and June 2023. The inclusion criterion was surgical treatment for evacuation of symptomatic macro-centimetric calcification (CA) type A or B. The first 20 patients were operated on using the standard surgical technique and the next 20 under ultrasound control.The mean age at surgery was 49.8 years (minimum: 28 years; maximum: 64 years). Patients were reviewed at 6 weeks and 3 months. The evacuation of the CA was checked at 6 weeks by X-ray. ResultsIn the standard technique group, the mean preoperative Constant score was 41.4/100 (± 15.07). Postoperatively, the Constant score was 58.88/100 (± 15.28) at 6 weeks and 69.16/100 (± 13.86) at 3 months. The mean preoperative Subjective Shoulder Value (SSV) was 39.0% (± 18.61). Postoperatively, the SSV was 64.0% (± 17.21) at 6 weeks and 79.47% (± 16.06) at 3 months.In the ultrasound control group, the preoperative Constant score was 44.48/100 (± 14.28) and 58.18/100 (± 15.64) at 6 weeks and 66.87/100 (± 18.45) at 3 months postoperatively. The mean preoperative SSV was 40.0% (± 16.54) and 61.75% (± 18.59) at 6 weeks and 76.05% (± 19.62) at 3 months postoperatively.There was no significant postoperative difference in Constant score (p=0.732) or SSV (p=0.566) between the two groups.There was a significant difference (p=0.004) between the two groups in terms of complete evacuation of the CA with the standard technique in 65% of cases (13 patients out of 20) and with intraoperative ultrasound monitoring in 95% of cases (19 patients out of 20). ConclusionThere was no significant postoperative difference in Constant score and SSV between the two groups in the short term.