Shoulder Tendonitis Repaired with 2-Needle Procedure

A new method liquefies the hard, painful calcium deposits in calcific tendonitis of the shoulder, removing them permanently, a new study reports.

Researchers at Azienda Ospedaliera Ospedale Santa Corona (Pietra Ligure, Italy) and the University of Genova (Italy) developed a method using ultrasound guidance to inject saline solution directly into the encapsulated calcium deposit through a 14- to 16-gauge needle, which is inserted into the bursa and directed into the nucleus of the calcium deposit. The saline washes the tendon, causing the calcium deposit to break up and liquefy, and allow its complete extraction. At the end of the procedure, the surgeons inject a small dose of steroid in the subacromion-subdeltoid bursa. The entire procedure takes approximately 15 minutes.

The researchers performed the procedure on 2788 patients, ranging in age from 29 to 73 years, with peak occurrence between 30 and 40 years of age. The prevalence ratio of women to men was 3:2. The researchers were able to completely extract the calcium deposit from 70.1% of shoulders, with more than 50% successful extraction from another 23.5%, a total success rate of 93.6%. There was a success rate of less than 50% in 4.1% and no improvement in only 2.1% of patients, which may reflect multiple calcifications. No recurrence of tendonitis occurred at one-year follow-up.

"This is the first time that this 2-needle procedure has been used; there was a fear that the larger needle that we used would cause tears, and that the pressure of the saline injection would cause the bursa to rupture,” said lead author Luca M. Sconfienza, M.D., from the department of radiology at Ospedale Santa Corona. "This did not happen. Precise guidance with ultrasound reduces this risk.”

Calcific tendonitis infringes on the blood and nerve supply in the shoulder and can cause permanent damage to the joint and limb if untreated.


Related Links:
Azienda Ospedaliera Ospedale Santa Corona
University of Genova