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Rotator cuff bursal side tear after calcium deposit removal: Should we suture it or not?
ESSKA Academy. Magnitskaya N. Nov 8, 2019; 284414; epESA-25
Topic: Arthroscopic Surgery
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Rotator cuff bursal side tear after calcium deposit removal: Should we suture it or not?
ePoster - epESA-25
Topic: Other Surgical Options
Magnitskaya N.1, Logvinov A.1,2, Ryazantsev M.1, Ilyin D.1, Afanasyev A.1, Korolev A.1,2
1European Medical Center, European Clinic of Sports Traumatology and Orthopaedics, Moscow, Russian Federation, 2Peoples Friendship University of Russia, Traumatology and Orthopedics, Moscow, Russian Federation
Introduction: Calcific tendinitis of shoulder rotator cuff is reported to be one of the most common causes of atraumatic shoulder pain. For patients resistant to conservative therapy, arthroscopic surgery is the remaining option.
Objectives: We hypothesized that arthroscopic suturing of rotator cuff after calcium deposit removal would result in superior outcomes to arthroscopic debridement.
Aims: The aim of the study was to compare the results of rotator cuff calcific tendinitis surgical treatment with arthroscopic repair versus debridement.
Methods: The study is a retrospective review of patients with diagnosed calcific tendinitis of the rotator cuff, treated surgically. Calcium deposits on preoperative MRI were classified according to Bosworth, Mole, Loew, Gartner and Heyer. Based on type of surgical procedure all patients were divided into two groups: Group 1 - deposit removal and rotator cuff repair; Group 2 - deposit removal and rotator cuff debridement. Evaluation of long-term results was conducted by three subjective scales: Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons shoulder score (ASES) and QuickDash score (QDS). Medians and interquartile ranges (IQR) were reported. Level of significance was defined as p< 0,05.
Results: In all cases calcium deposits were located in supraspinatus tendon. After surgical deposit excision the median length of tear accounted 10 mm (IQR 8-14), all tears were bursal side Ellman grade 2 and 3. Group 1 comprised 13 patients, median age - 51 year (IQR 45-57). Group 2 included 7 patients, median age 52 years (IQR 48-60). According to Bosworth, Mole, Gartner and Heyer and Loew classifications Group 1 and 2 had no differences in calcium deposit characteristics (p>0,05). Median follow-up in both groups accounted 12 months. Within both groups, all scores improved significantly, as compared to preoperative numbers (p < 0.05). However no statistical differences were observed between Group 1 and 2 at time of follow up in median subjective scores (VAS - 1; ASES - 100; QDS - 2,3 in Group 1 versus VAS - 2; ASES - 91,6; QDS - 2,3 in Group 2; p>0,05).
Conclusions: No differences were present at 12 months postoperatively between rotator cuff repair and debridement following calcium deposit removal as assessed by VAS, ASES and QDS scales. In our opinion the necessity of rotator cuff suturing after calcium deposit excision requires further discussion.
ePoster - epESA-25
Topic: Other Surgical Options
Magnitskaya N.1, Logvinov A.1,2, Ryazantsev M.1, Ilyin D.1, Afanasyev A.1, Korolev A.1,2
1European Medical Center, European Clinic of Sports Traumatology and Orthopaedics, Moscow, Russian Federation, 2Peoples Friendship University of Russia, Traumatology and Orthopedics, Moscow, Russian Federation
Introduction: Calcific tendinitis of shoulder rotator cuff is reported to be one of the most common causes of atraumatic shoulder pain. For patients resistant to conservative therapy, arthroscopic surgery is the remaining option.
Objectives: We hypothesized that arthroscopic suturing of rotator cuff after calcium deposit removal would result in superior outcomes to arthroscopic debridement.
Aims: The aim of the study was to compare the results of rotator cuff calcific tendinitis surgical treatment with arthroscopic repair versus debridement.
Methods: The study is a retrospective review of patients with diagnosed calcific tendinitis of the rotator cuff, treated surgically. Calcium deposits on preoperative MRI were classified according to Bosworth, Mole, Loew, Gartner and Heyer. Based on type of surgical procedure all patients were divided into two groups: Group 1 - deposit removal and rotator cuff repair; Group 2 - deposit removal and rotator cuff debridement. Evaluation of long-term results was conducted by three subjective scales: Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons shoulder score (ASES) and QuickDash score (QDS). Medians and interquartile ranges (IQR) were reported. Level of significance was defined as p< 0,05.
Results: In all cases calcium deposits were located in supraspinatus tendon. After surgical deposit excision the median length of tear accounted 10 mm (IQR 8-14), all tears were bursal side Ellman grade 2 and 3. Group 1 comprised 13 patients, median age - 51 year (IQR 45-57). Group 2 included 7 patients, median age 52 years (IQR 48-60). According to Bosworth, Mole, Gartner and Heyer and Loew classifications Group 1 and 2 had no differences in calcium deposit characteristics (p>0,05). Median follow-up in both groups accounted 12 months. Within both groups, all scores improved significantly, as compared to preoperative numbers (p < 0.05). However no statistical differences were observed between Group 1 and 2 at time of follow up in median subjective scores (VAS - 1; ASES - 100; QDS - 2,3 in Group 1 versus VAS - 2; ASES - 91,6; QDS - 2,3 in Group 2; p>0,05).
Conclusions: No differences were present at 12 months postoperatively between rotator cuff repair and debridement following calcium deposit removal as assessed by VAS, ASES and QDS scales. In our opinion the necessity of rotator cuff suturing after calcium deposit excision requires further discussion.
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