The procedure is carried out arthroscopically, a minimally invasive surgical technique. The patient is put in the beach chair or lateral decubitus position, and mild traction is applied to the arm. The operation takes place in an operating theatre in compliance with strict standards of cleanliness and safety. The anaesthetist will decide on the most suitable anaesthetic together with the patient. This procedure is usually carried out under general anaesthesia. A pre-anaesthesia consultation before the operation, and possibly a pre-operative assessment, is conducted to minimise the risk of complications. The operation is planned during pre-surgical consultations. In this case, rehabilitation is preferred with balneotherapy to recover joint range of motion. In this situation, surgery would be pointless and it is therefore important to carry out 2 x-rays at least 3 months apart showing no change in the appearance of the calcification.įinally, before operating, it is necessary to ensure that the shoulder is not stiff, as this would indicate adhesive capsulitis secondary to the calcific tendonitis for which surgery is contraindicated. It is necessary to ensure beforehand that the calcification is not spontaneously resorbing, which can trigger or increase the pain and lead the patient to consult a surgeon. If the medical treatment does not relieve the pain, surgical treatment can be proposed. Surgical treatmentĪrthroscopic surgical treatment consists in removing the calcification and potentially giving the tendon more space by increasing the subacromial space. This treatment is often combined with corticosteroid injections in the calcium deposit and is only possible once the calcium deposit has softened (type C). The lavage and aspiration are ultrasound or x-ray-guided. Three sessions are recommended and the efficacy of this treatment varies from 10 to 70% depending on the studies. Shock waves are preferably indicated in the calcific stage when the calcium deposit is hard. These are acoustic waves, ideally high energy focused, delivered by a machine on the surface of the skin above the diseased tendon the aim of which is to loosen the calcium fixed to the tendon to eliminate it. X-ray-guided corticosteroid injections in the subacromial space can have beneficial effects, especially in the resorptive phase (type C) when there is significant inflammation of the subacromial bursa. What treatments are available? Medicinal treatments In the resorption phase, the calcium deposits firstly become more translucent then the edges become blurred and heterogeneous. It is dense and the edges are sharp in the formative and chronic phases. The radiographic morphology of the calcium deposits is the best indication of the stage. During this phase, the pain is intense, causing insomnia and it is impossible to actively move the arm.Īt the end of this phase, the tendon heals and recovers normally. The volume and tension of the calcium deposit increase, signs of inflammation appear and the pain is caused mainly by the inflammation of the subacromial bursa due to the calcium microcrystals released. Resorption phaseĭuring the resorption phase, the hard calcium deposit softens. This is known as sub-acromial impingement. Due to its increase in size, the tendon can also catch on the acromion, the bony arch overhanging the rotator cuff tendons, when moving the arm. The calcium deposit is very hard during this phase and the tendon pain often experienced is linked to the hyper-pressure created by the calcium deposit inside the tendon. The structure of the tendon changes around a calcium deposit giving rise to a calcification that continues to increase in size until it stabilises. The calcium deposits generally progress in 3 phases. Traumatic Shoulder Injuries Menu Toggle.Arthroscopic Removal of Rotator Cuff Calcium Deposits.Drilling, Fixation And Osteochrondral Grafts.Osteochondritis Dissecans Surgery Menu Toggle.Anterior Tibial Tuberosity Transfer Patella Realignment.Patellar Instability Surgery Menu Toggle.Medial Opening-Wedge High Tibial Osteotomy.Medial Closing-Wedge Distal Femoral Osteotomy.Surgery To Slow Knee Osteoarthritis Menu Toggle.Posterior Cruciate Ligament Reconstruction.Revision Anterior Cruciate Ligament Reconstruction.Anterior Cruciate Ligament Reconstruction (Kenneth-Jones).4-Strand Semitendinosus Tendon ACL Reconstruction.Minimally Invasive Anterior Approach Total Hip Replacement.
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