AOSSM 2022 Annual Meeting Recordings - no CME-Outcomes of Percutaneous Barbotage for Calcific Tendonitis of the Shoulder

Video Transcription

on outcomes of percutaneous barbiturates for calcific tendonitis of the shoulder. Note exclosures, this research was done at my fellowship at Hoag Orthopedic Institute.  So the background, calcific tendonitis, painful shoulder condition that can cause acute disabilitating  pain in patients, secondary deposition and resortion of calcium deposits within the rotator cuff tendon.  So the workup, we typically start with the history with the sudden pain of insidious onset, extreme pain that can even bring patients to the ER or urgent care, X-ray and then MRI  if there's concern for concomitant rotator cuff pathology. So here's an X-ray showing that nice chunk of calcium in the supraspinatus.  So the treatment options, we've always started with oral anti-inflammatories, steroid injection, either oral or subacromial.  And then there's been talks of extracorporeal shockwave, the needle barbiturates, and ultimately surgical decompression with or without a rotator cuff repair.  So the methods for our study, all patients were seen and treated at a single center. They were first evaluated by a fellowship-trained orthopedic sports medicine surgeon or shoulder  elbow surgeon. And then a single fellowship-trained primary care sports medicine performed the procedure. So for the procedure, the calcium deposit was identified under ultrasound.  The skin at the site of entry in the subacromial space were anesthetized using 10 cc's of 1%  and an 18 gauge needle was inserted into the calcium deposit under the ultrasound, aspirated, and then ultimately steroids injected. So this is that same patient.  You can see the calcium deposit on the X-ray and this is afterwards, immediately after the procedure, it's completely gone.  So results, since 2018, 22 patients had undergone the procedure, 19 opted in. About 73% were female, 27 male.  The majority of the patients also had at least one significant medical comorbidity, and the average age being 56, with quite a wide range of 31 to 76 years old.  So the average follow-up time was around one year after this. And then the SANE score for the affected extremity was 81, while the unaffected was 91.  This approached significance but didn't quite make it. I think the big takeaway from this is of all 19 patients that underwent this, not a  single one ended up going into surgery in the prospective follow-up time. So conclusion, the needle barbatage is a safe and effective way to treat calcific tendonitis  that may prevent the surgical treatment for it. All right, thanks guys.

Video Summary

In this video, the speaker discusses the outcomes of using percutaneous barbiturates for calcific tendonitis of the shoulder. They explain that calcific tendonitis is a painful shoulder condition caused by calcium deposits in the rotator cuff tendon. The workup involves history, X-rays, and MRI. Treatment options include oral anti-inflammatories, steroid injections, shockwave therapy, needle barbiturates, and surgical decompression. The study was conducted at a single center, with patients evaluated by orthopedic surgeons before a primary care sports medicine doctor performed the procedure. Results show that the procedure successfully treated the condition in all 19 patients, eliminating the need for surgery. The speaker concludes that needle barbatage is a safe and effective alternative for calcific tendonitis treatment.

Asset Caption

Troy Shields, MD

Keywords

percutaneous barbiturates

calcific tendonitis

shoulder condition

needle barbiturates

treatment options