Arthroscopic calcification removal

Shoulder calcification is defined as aggregation of calcium (carbonatappatit) in the tendons of the rotator cuff which may be caused by various factors. In most cases, the supraspinatus tendon is affected.
The disease commonly occurs in the 4th and 5th decade of life and predominantly affects women.
Typically, there are alternating phases of complete absence of pain and highly acute pain.

Treatment objective

The objective of conservative treatment is to reduce pain. If this cannot be achieved by means of conservative measures, surgical removal of the calcium deposit is indicated.

Surgery technique

Surgical removal of the calcium deposit is performed transarthroscopically (closed). First, the subacromial space is examined endoscopically (arthroscopy) in order to locate the calcium deposit. This is done by "palpating" the rotator cuff using a needle until the needle tip detects calcium. In this area, the tendon is cut in filament direction using a scalpel. This already triggers emptying of the calcium deposit. The visible calcium is removed using a sharp spoon and motor-driven instruments. The cut in the tendon remains and heals without any problems.
Depending on radiology imaging, pain and the intraoperative findings, arthroscopic subacromial decompression has to be performed subsequently in exceptional cases.

Fig. 23: Calcifying tendonitis before surgery.

Fig. 24: Shoulder after the removal of the calcific deposit.

Follow-up treatment

From the first day after surgery, the arm may be moved within the painless range on a physiotherapist's instructions. This is necessary in order to prevent adhesions. A return to work is possible after 3 - 4 weeks. Patients performing heavy physical work or predominantly work above their head will need prolonged rehabilitation of 6 - 12 weeks.
With the ability to work, recreational activities may usually be resumed as well. The time of resuming an individual training depends on the specific strain on the shoulder girdle.