Calcific tendonitis of the shoulder; when should we operate?

Introduction: This study aimed to determine patient factors associated with the failure of nonoperative management of calcific tendonitis and subsequent operative intervention. The secondary aim was to assess whether the size of the calcific deposit can determine the need for surgery, as shown by previous studies in the literature.

Methods: A retrospective review of a prospectively maintained database of a consecutive series of patients diagnosed with calcific tendonitis attending a single hospital trust orthopaedic department between 2014 and 2018 was performed. Data were collected on the size and location of the calcium deposit, comorbidities, Oxford Shoulder Score and functional range of movement.

Results: A total of 61 patients were included. Factors associated with the failure of nonoperative management were: size of calcific deposit >10mm (p=0.009), female sex (p=0.005), a chronic condition of more than eight months duration (p=0.001), failed previous treatment (still symptomatic after previous management, requiring treatment) (p=0.001) and patients for whom steroid injections did not control their symptoms (p=0.02).

Conclusions: Patients with a calcific deposit larger than 10mm, who are female, or have had symptoms for more than eight months are more likely to require surgery. Those with a transient response to steroid injections and or physiotherapy are also more likely to require surgical management.