Department for Orthopaedics and Orthopaedic Surgery, General Hospital of Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1792-4. doi: 10.1007/s00167-010-1227-9. Epub 2010 Aug 20.
Calcifying tendinitis is a common condition of the shoulder. In many cases, arthroscopic reduction in the deposit is indicated. The localization of the deposit is sometimes challenging and time-consuming. Pre-operative ultrasound (US)-guided needle placement in the deposit and pre-operative US marking of the deposit at the skin with a ballpoint are described and recommended methods to alleviate the procedure without using ionizing radiation by fluoroscopy.
Intra-operative sonography of the shoulder is introduced as a new method to localize the calcific deposit with high accuracy. After standard arthroscopic buresectomy, the surgeon performs an ultrasound examination under sterile conditions to localize the deposits. A ventral longitudinal US section is recommended, and the upper arm is rotated until the deposit is visible. Subsequently, perpendicular to the skin at the position of the transducer, a needle is introduced under arthroscopic and ultrasound visualization to puncture the deposit.
The presence of snow-white crystals at the tip of the needle proves the exact localization. Consecutively, the curettage can be accomplished. Another intra-operative sonography evaluates possible calcific remnants and the tendon structure.
This new technique may alleviate arthroscopic calcific deposit curettage by visualizing the deposit without using ionizing radiation. Additionally, soft tissue damage due to decreased number of punctures to detect the deposit may be achieved. Both factors may contribute to reduced operation time.
钙化性肌腱炎是肩部的一种常见疾病。在许多情况下，需要进行关节镜下的沉积物复位。沉积物的定位有时具有挑战性且耗时。描述了术前超声（US）引导下在沉积物中放置针头以及术前 US 在皮肤上用圆珠笔标记沉积物的方法，并推荐了一些无需使用透视的方法来减轻该过程，而无需使用电离辐射。
肩部术中超声检查被引入作为一种新的方法，可高精度定位钙化沉积物。在标准关节镜下肱二头肌切除术之后，外科医生在无菌条件下进行超声检查以定位沉积物。建议进行腹侧纵向 US 切面，然后旋转上臂，直到可见沉积物。随后，在超声可视化引导下，在与换能器垂直的位置，将针引入以穿刺沉积物。
针尖出现雪白色晶体证明了准确的定位。随后可以进行刮除术。另一种术中超声检查评估可能存在的钙化残留物和肌腱结构。
该新技术可通过可视化沉积物而无需使用电离辐射来减轻关节镜下钙化沉积物刮除术。此外，通过减少探测沉积物所需的穿刺次数，可能减少软组织损伤。这两个因素都可能有助于缩短手术时间。
