Calcific Tendinopathy of the Rotator Cuff. Current Solutions
Rómulo Silva*, Alice Pimentel and Manuel Gutierres
Objective: Systematic review of the current treatment options for Calcific Tendinopathy of the Rotator Cuff
Materials and Methods: The information was obtained using the Pubmed database using the following keywords: "calcific", "tendinopathy", "tendinitis", "rotator", "cuff", "shoulder", "treatment". The search was restricted to articles in English or Portuguese, less than 10 years old. Eight articles were included prior to the date defined by their singular relevance to the topic. After selection, 48 articles were consulted.
Results: The treatment of calcific tendinopathy of the rotator cuff involves several lines of treatment, to be carried out successively. The initial, conservative, non-invasive approach includes the use of non-steroidal anti-inflammatory drugs and oral analgesics, physical therapy (with extra-body shock waves) and corticosteroids (oral or intramuscular), aiming mainly to act in the reduction of symptoms. In the second line of treatment, already invasive, we highlight the infiltration with corticoids (diluted in lidocaine) and the ultrasound-guided “barbotage”, which acts not only in the symptoms, but also in the resolution of the underlying pathology, with excellent proven results. Finally, arthroscopic surgery is an approach withgood success rates, limited by its invasiveness, cost and possible complications.
Conclusions: Taking into account the self-limited nature of the pathology, conservative treatment is the first choice, having undergone advances with the inclusion of iontophoresis, extracorporeal shock wave therapy and echo-guided needle washing. Arthroscopic treatment is reserved for the failure of other treatments.