Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
Arthroscopy. 2013 May;29(5):824-31. doi: 10.1016/j.arthro.2013.01.031. Epub 2013 Apr 6.
We sought to evaluate (1) clinical and radiologic results after arthroscopic calcific deposit (CD) removal and (2) the relevance of remnant calcifications (RCs).
The study included 102 patients undergoing arthroscopic CD removal, preserving integrity of the rotator cuff. Postoperatively, we divided patients into 2 groups according to the extent of CD removal achieved. Group 1 consisted of patients with complete CD removal. Group 2 included patients showing minor RCs. Ninety-three patients (99 shoulders) completed follow-up. The mean patient age was 50.6 years (31 to 68 years), and the mean follow-up period was 37.3 months (24 to 83 months). We obtained anteroposterior (AP) and outlet radiographs before surgery, postoperatively, and at follow-up. We used the absolute and age- and sex-related Constant scores (CSabs, CSrel) as outcome measures. We compared both groups statistically (Mann-Whitney U test; P < .05).
Complete CD removal was achieved in 82 of 99 (82.8%) shoulders (group 1). Postoperatively, minor RCs were found in 17 of 99 (17.2%) shoulders (group 2), an average of 58.6% (± 26.2) of the mean preoperative size. All RCs showed complete (14 of 17) or virtually complete (3 of 17) resolution at follow-up. Overall mean CSabs and CSrel were 88.8 points (± 10.4) and 99.0% (± 3.7), respectively. Mean values of CSabs and CSrel in group 1 (89.5 points ± 9.5 and 99.1% ± 3.7, respectively) and group 2 (86.1 points ± 12.9 and 98.7% ± 4.2, respectively) did not differ.
Arthroscopic CD removal, preserving integrity of the rotator cuff yielded good to excellent results in 90% of patients and avoided iatrogenic tendon defects in all patients. Minor RCs did not impair clinical outcome and spontaneously resolved at follow-up.
Level IV, therapeutic case series.
我们旨在评估（1）关节镜下钙化沉积物（CD）清除后的临床和影像学结果，以及（2）残余钙化（RCs）的相关性。
本研究纳入了 102 例行关节镜下 CD 清除术的患者，且保留了肩袖的完整性。术后，我们根据 CD 清除的程度将患者分为两组。组 1 为完全清除 CD 的患者，组 2 为有少量 RC 的患者。93 例患者（99 肩）完成了随访。患者平均年龄为 50.6 岁（3168 岁），平均随访时间为 37.3 个月（2483 个月）。我们在术前、术后和随访时获得前后位（AP）和出口位 X 线片。我们使用绝对和年龄及性别相关的 Constant 评分（CSabs，CSrel）作为结果测量指标。我们对两组数据进行了统计学比较（Mann-Whitney U 检验；P<.05）。
99 肩中的 82 肩（82.8%）实现了完全清除 CD（组 1）。术后，99 肩中有 17 肩（17.2%）发现少量 RC（组 2），平均为术前大小的 58.6%（±26.2）。所有 RC 在随访时均完全（14 例）或几乎完全（3 例）溶解。总体平均 CSabs 和 CSrel 分别为 88.8 分（±10.4）和 99.0%（±3.7）。组 1 的 CSabs 和 CSrel 平均值分别为 89.5 分（±9.5）和 99.1%（±3.7），组 2 分别为 86.1 分（±12.9）和 98.7%（±4.2），两组间无差异。
关节镜下保留肩袖完整性的 CD 清除术在 90%的患者中取得了良好至优秀的结果，并且避免了所有患者的医源性肌腱缺损。少量 RC 并未影响临床结果，且在随访时自发缓解。
IV 级，治疗性病例系列。
