Return to Sports After Arthroscopic Treatment of Rotator Cuff Calcifications in Athletes

Abstract

Background:Arthroscopic treatment of calcific deposits of rotator cuff tears has been described with successful results in the general population. However, despite the high frequency of this condition, there is no information in the literature regarding arthroscopic treatment of rotator cuff calcifications in athletes.Purpose:To analyze the time to return to sport, clinical outcomes, and complications of complete arthroscopic removal of intratendinous calcific deposits and repair of the tendon lesion without acromioplasty in athletes.Study Design:Case series; Level of evidence, 4.Methods:This study retrospectively evaluated 24 consecutive patients with a mean age of 36.2 years. The mean follow-up was 59 months (range, 24-108 months). Patients completed a questionnaire focused on the time to return to sport and treatment course. Pre- and postoperative functional assessment was performed using the Constant score and University of California Los Angeles (UCLA) score. Pain was assessed by visual analog scale (VAS). Radiographs and magnetic resonance imaging (MRI) were performed to evaluate the recurrence of calcifications and the indemnity of the supraspinatus tendon repair.Results:Of the 24 patients, 23 (95.8%) were able to return to sports; 91.3% returned to the same level. The mean time to return to play was 5.3 months (range, 3-9 months): 26% of patients (6/23) returned to sports in less than 4 months, 61% (14/24) returned between 4 and 6 months, and 13% (3/24) returned after the sixth month. The mean Constant score increased from 26.9 preoperatively to 89.7 postoperatively (P < .001), and the UCLA score increased from 17.3 preoperatively to 33.2 postoperatively (P < .001). Significant improvement was obtained for pain (mean VAS, 8.4 [before surgery] vs 0.6 [after]; P < .001). The overall majority (91.6%) of patients were satisfied with their result. MRI examination at last follow-up (79% of patients) showed no tendon tears.Conclusion:In athletes with calcifying tendinitis of the supraspinatus tendon with failed nonoperative treatment, complete arthroscopic removal of calcific deposits and tendon repair without acromioplasty results in significant pain relief and improvement in functional outcomes. Most patients return to the same level of proficiency regardless of the type of sport and the level of competition before injury, with 91.6% of patients satisfied with their results.

Clinical and Structural Results of Rotator Cuff Repair Compared With Rotator Cuff Debridement in Arthroscopic Treatment of Calcifying Tendinitis of the Shoulder

“…2,12,[15][16][17]20 Moreover, most patients return to the same level of sporting activity regardless of the type of sport and the level of competition before injury. 18 Calcifying tendinitis does not seem to predispose patients to additional rotator cuff tears, as these 2 entities likely arise from different pathological processes. 4 However, some authors favor partial removal of the calcific deposit to decrease potential damage of the tendon during surgery 7,19 and report good clinical results as well.…”

“…2,12,15–17,20 Moreover, most patients return to the same level of sporting activity regardless of the type of sport and the level of competition before injury. 18…”

Return-to-Sport Criteria After Upper Extremity Surgery in Athletes—A Scoping Review, Part 1: Rotator Cuff and Shoulder Stabilization Procedures

“…22,35 Fewer studies have examined the rate of RTS after rotator cuff repair in athletes given the decreased incidence of the procedure in this population. 24,46,49,59 Similar to RTS criteria after shoulder stabilization surgery (SSS), the RTS criteria after rotator cuff repair are not validated. Although shoulder instability is often the primary indication for shoulder arthroscopy in athletes, preexisting rotator cuff lesions may be corrected during the same procedure.…”

“…a HAGL, humeral avulsion of the glenohumeral ligament.||References 2,5,10,15,21,24,31,33,46,49,54,55,58,59. { used as the RTS criterion in 23 of 52 studies (44%).…”

“…40 However, this is not a common scenario, and most of the studies reporting the RTS rate after rotator cuff repair include physically active patients who are younger than 65 years. 10,33,46,55 Furthermore, no data are available to suggest that these heterogeneous criteria are utilized in either preventing recurrent injury or optimizing athletic performance. In a systematic review of RTS criteria after anterior stabilization surgery, Ciccotti et al 16 found that time from surgery to RTS was the only criterion explicitly used.…”