Objectives: The aim of this study was to evaluate whether removing the calcifications in the rotator cuff tendons during surgical subacromial decompression improves outcome in patients with calcific tendonitis. Methods: Two groups of 20 patients with a subacromial impingement syndrome and cuff calcifications were operated on. In group A, patients had an anterolateral acromioplasty according to Neer with excision of calcifications. In group B, the same procedure was performed without additional excision of calcifications. After a minimum follow-up of 3 years the patients were assessed with the disabilities of arm, shoulder and hand score (DASH), the visual analogue scale (VAS) for pain, measurements of range of motion (ROM) in all planes, and satisfaction with treatment. Results: The results for the DASH score, ROM, VAS and satisfaction with treatement showed no significant difference between the two groups. Conclusion:The results of our study suggest that removal of calcific deposits with anterolateral acromioplasty does not influence patient outcome. Further prospective studies are needed to determine the optimal surgical treatment for calcific tendonitis. C alcific tendonitis of the shoulder is a common and painful disorder and is characterised by calcifications in the tendons of the rotator cuff (fig 1). The incidence in the healthy population is 2.7%, rising to 6.8% in patients with shoulder pain.1 2 The predominant age is 30-60 years and women are affected slightly more often than men. The calcifications are most often seen in the tendon of the supraspinatus muscle.1 Risk factors for shoulder pain due to problems of the rotator cuff include overhead activities and sports.3 4 The treatment of choice is primarily conservative. This includes rest, physiotherapy, non-steroidal anti-inflammatory drugs and at a later stage a subacromial infiltration with corticosteroids. When conservative treatment fails, surgery can be recommended. In most studies on surgical treatment of calcific tendonitis, removal of the calcifications in combination with a subacromial decompression is only recommended when there are signs of subacromial irritation. [5][6][7][8][9][10][11] However, it has also been advocated that a subacromial decompression alone might be sufficient, stating that the calcifications will dissolve as a matter of natural course. 12 The aim of this study was to evaluate whether it is beneficial for patient outcome to remove the calcifications of the tendons of the rotator cuff when performing a subacromial decompression. MATERIALS AND METHODS PatientsA total of 40 patients (27 women and 13 men) with calcific tendonitis were selected for this retrospective cohort study performed at the St. Elisabeth Hospital in Tilburg, the Netherlands. Two treatment groups (A and B) were defined and treated accordingly. In group A, an open acromioplasty was performed with removal of the calcifications of the rotator cuff. In group B, an open acromioplasty was performed without removal of the calcifications. Four orthopaedic surge...

To our knowledge, this is the first case of a traumatic atlantoaxial rotatory dislocation with accompanying odontoid and C2 superior articular facet fracture.

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