ISOLATED SUBACROMIAL DECOMPRESSION FOR THE TREATMENT OF CHRONIC SHOULDER PAIN WITH ROTATOR CUFF CALCIFICATION - A REVIEW OF 27 SHOULDERS, INCLUDING 18 EVALUATED BY MAGNETIC-RESONANCE-IMAGING AFTER SURGERY

We conducted a retrospective study of functional results and imaging s tudy changes after isolated anterosuperior decompression of 27 chronic ally painful shoulders with calcification of the supraspinatus tendon at the time of surgery (n=22) or at an earlier date (n=5). Mean durati on of pain at surgery was 4.5 years. Mean time between surgery and eva luation of results was three years. Absence of pain and full range of motion were noted in most cases (70%), usually after four to six month s. There were no postoperative exacerbations of pain. The best results were obtained in those patients with a heterogeneous supraspinatus ca lcification. Most calcifications (18/22) disappeared within one year o f surgery. Magnetic resonance imaging findings at last follow-up are r eported for 18 shoulders. Functional results were nearly as good as th ose reported after calcification removal. In patients with shoulder pa in and rotator cuff tendon calcifications who fail to respond to conse rvative therapy and aspiration with lavage, anterosuperior decompressi on may be the treatment of choice when the calcification is either het erogeneous and located within the tendon or no longer visible. In cont rast, curettage may be the best treatment for superficial homogeneous calcifications that can be removed without damaging the rotator cuff.