[Translated article] Rotator cuff debridement compared with rotator cuff repair in arthroscopic treatment of calcifying tendinitis of the shoulder: A systematic review and meta-analysis

• Published in: Revista española de cirugía ortopédica y traumatología 2024-11
• Main Authors: González-Martín, D., Garrido-Miguel, M., de Cabo, G., Lomo-Garrote, J.M., Leyes, M., Hernández-Castillejo, L.E.
• Format: Article
• Language: English
• Subjects: Calcific deposit; Calcifying tendinitis; Clinical outcomes; Depósito calcificado; Hombro; Manguito rotador; Resultados clínicos; Rotator cuff; Shoulder; Tendinitis calcificante
• ISSN: 1888-4415; 1988-8856
• DOI: 10.1016/j.recot.2024.11.003

Although conservative treatment of calcific tendinopathy has a high success rate, arthroscopic excision of the calcific deposit is occasionally necessary. Controversy exists as to whether the remaining rotator cuff defect can be left in situ or should be repaired to achieve better functional outcomes. This study aimed to compare the results of debridement versus debridement combined with suturing in arthroscopic surgery for calcific tendinopathy. MEDLINE, EMBASE, Cochrane Library, and Web of Science were searched from inception to February 2023 for articles on arthroscopic treatment of calcific tendinopathy. Functional outcomes (VAS, ASES, UCLA, and Constant) and the number of complications were analyzed. The effect size was calculated using Cohen's d-index. Twenty-one studies were included, including a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The combined ES estimates for the total score of the VAS, ASES, UCLA, and Constant scales were very strong (>1.0) for both debridement and combined debridement with suture. The ES estimates for the number of total complications were 1.75 (95% CI: 0.08–3.43, I2=0%) for debridement and 9.07 (95% CI: −0.03 to 18.17, I2=50.4%) for combined debridement with suture. Both arthroscopic procedures improve the total score significantly on the EVA, ASES, UCLA, and Constant scales. However, a higher proportion of complications was observed in the group that performed suturing. In this regard, we must consider whether it is really necessary to repair all partial tears after the calcified deposits removal. Aunque el tratamiento conservador de la tendinopatía calcificante tiene una alta tasa de éxito, ocasionalmente es necesario realizar exéresis artroscópica del depósito cálcico. Existe controversia en si el defecto que queda en el manguito rotador puede dejarse in situ o debe repararse para conseguir mejores resultados funcionales. El objetivo de este estudio fue comparar los resultados del desbridamiento frente al desbridamiento combinado con sutura en la cirugía artroscópica de la tendinopatía calcificante. Se realizó una búsqueda en MEDLINE, EMBASE, Cochrane Library y Web of Science desde el inicio hasta febrero de 2023 de artículos sobre tratamiento artroscópico de tendinopatía calcificante. Se analizaron los resultados funcionales (EVA, ASES, UCLA y Constant), y el número de complicaciones. El tamaño del efecto se calculó mediante el índice d de Cohen. Se incluyeron 21 e