Isolated acromioplasty for calcific tendinitis produces good results at 3-year follow-up

Verstraelen, Freek; Glimmerveen, Nanda W.; Janssen, Loes; Morrenhof, Wim

doi:10.1097/bco.0000000000000240

Cited by 2 publications

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References 22 publications

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“…The two groups in this study were patients with calcifying and non-calcifying tendinitis of the rotator cuff and no differences were apparent in the functional outcome. In both studies, complete disappearance or significant decrease in size of the calcifications was frequently observed [ 12 , 13 , 25 ]. Therefore, it can be hypothesized that the surgical procedure with the SAD serves as a stimulus for the tendon to return to the resorption phase.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial

et al. 2022

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Background A preferable surgical treatment for patients with conservative therapy-resistant calcifying tendinitis of the shoulder is still a matter of debate. Therefore, the purpose of this study was to evaluate and compare short-term clinical and radiological results of three surgical treatment options for these patients. Methods A multicenter randomized trial was conducted. Sixty-nine patients were randomly assigned to receive 1. subacromial decompression (Group SAD), 2. debridement of calcifications (Group D), or 3. debridement of calcifications with SAD (Group D + SAD). Stringent inclusion and exclusion criteria were used. The primary outcome was an improvement in VAS for pain (pVAS) 6 months postoperatively. Secondary outcomes were an improvement in pVAS 6 weeks postoperatively, functional outcomes (CMS, DASH, ASES), radiological outcome, additional treatments, and complications. Results The improvement in pVAS was significant in all groups (p < 0.001) and did not differ between the groups after 6 months. Six weeks postoperatively, the improvement in pVAS was significantly (p = 0.03) less in Group SAD compared to Group D + SAD (16.5 mm, SD 19.3 mm vs 33.1 mm, SD 19.7 mm, respectively). The mean size of calcifications decreased significantly in all groups (p < 0.0001). In Group SAD, the size of the calcifications decreased less (p = 0.04) compared to Group D and Group D + SAD after 6 weeks. Group SAD received more additional treatments (p = 0.003) compared to Group D + SAD (9 vs 1), which were mainly subacromial cortisone injections. Conclusions All patient groups showed significant pain relief and an improvement in shoulder function 6 months after surgery. However, patients in Group SAD showed inferior pain relief and less improvement in DASH score after 6 weeks. Furthermore, this group required more postoperative additional treatments. No significant differences in clinical and radiological outcomes were observed between patients in Group D compared to Group D + SAD. Therefore, an arthroscopic debridement without subacromial decompression seems to be advisable for patients with therapy-resistant calcifying tendinitis of the shoulder. Level of evidence 2, Open-Label Randomized Clinical Trial. IRB METC Zuyderland MC. Number: 14-T-112. Registered at trialregister.nl NL 4947.

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Section: Discussionmentioning

confidence: 99%

Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial

et al. 2022

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Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial.

Verstraelen

Schotanus

Klemann-Harings

et al. 2022

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Background: A preferable surgical treatment for patients with conservative therapy resistant calcifying tendinitis of the shoulder is still a matter of debate. Therefore, the purpose of this study was to evaluate and compare short-term clinical and radiological results of three surgical treatment options for these patients. Methods: A multicenter randomized trial was conducted. 69 patients were randomly assigned to receive 1. subacromial decompression (Group SAD), 2. debridement of calcifications (Group D), or 3. debridement of calcifications with SAD (Group D+SAD). Stringent inclusion and exclusion criteria were used. Primary outcome was improvement in VAS for pain (pVAS) six months postoperatively. Secondary outcomes were improvement in pVAS six weeks postoperatively, functional outcome (CMS, DASH, ASES), radiological outcome, side treatments and complications. Results: The improvement in pVAS was significant in all groups (p<0.001) and did not differ between the groups after six months. Six weeks postoperatively, the improvement in pVAS was significantly (p=0.03) less in Group SAD compared to Group D+SAD (16.5mm, SD 19.3mm vs 33.1mm, SD 19.7mm, respectively). The mean size of calcifications decreased significantly in all groups (p<0.0001). In Group SAD the size of the calcifications decreased less (p=0.04) compared to Group D and group D+SAD after six weeks. Group SAD received more side treatments (p=0.003) compared to Group D+SAD (9 vs 1), which were mainly subacromial cortisone injections. Conclusions: All patient groups showed significant pain relief and improvement of shoulder function six months after surgery. However, patients in group SAD showed inferior pain relief and improvement in DASH score after six weeks. Furthermore, this group required more postoperative side treatments. No significant differences in clinical and radiological outcomes were observed between patients in group D compared to group D+SAD. Therefore, an arthroscopic debridement without subacromial decompression seems to be advisable for patients with therapy resistant calcifying tendinitis of the shoulder. Level of evidence: 2, Open Label Randomized Clinical Trial. IRB: METC Zuyderland MC. Number: 14-T-112. Registered at trialregister.nl: NL 4947

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Isolated acromioplasty for calcific tendinitis produces good results at 3-year follow-up

Cited by 2 publications

References 22 publications

Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial

Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial

Comparison of clinical and radiological outcomes after three different surgical treatments for resistant calcifying tendinitis of the shoulder: a short-term randomized controlled trial.

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