What’s involved in shoulder calcific tendonitis surgery?

Shoulder calcific tendonitis is a painful condition caused by calcium deposits building up in the tendons of the rotator cuff. While many patients respond well to non-surgical treatments, some require surgery if symptoms persist. Surgical treatment aims to remove the calcium deposits, relieve pain and restore shoulder movement.

What is shoulder calcific tendonitis?

Calcific tendonitis occurs when calcium deposits form within the rotator cuff tendons – most commonly in the supraspinatus tendon. These deposits can cause inflammation and intense pain, especially when the arm is raised. The condition usually affects adults between the ages of 30 and 50 and may develop without a clear cause.

What are the symptoms?

• Sudden or gradual onset of shoulder pain
• Pain that worsens with shoulder movement, especially lifting
• Reduced range of motion
• Pain at night that can interfere with sleep
• Weakness in the affected arm

When is surgery necessary?

Most cases can be managed with non-surgical options such as rest, physiotherapy, anti-inflammatory medication, corticosteroid injections or ultrasound-guided barbotage (needling and lavage). However, surgery may be recommended if:

• Pain persists despite several months of treatment
• Calcium deposits are large or causing significant inflammation
• There is restricted movement or tendon damage

What happens during surgery?

Surgery for calcific tendonitis is usually performed arthroscopically – a type of keyhole surgery using a camera and small instruments inserted through tiny incisions.

The procedure typically involves:

1. Arthroscopic assessment: The surgeon uses a small camera to inspect the shoulder joint and confirm the location and extent of the calcium deposits.
2. Removal of calcium deposits: Special instruments are used to carefully extract the deposits from the tendon. If the deposit has ruptured into surrounding tissue, the area is cleaned to reduce inflammation.
3. Tendon repair (if needed): In some cases, the removal of the calcium may leave a defect in the tendon that needs to be repaired using sutures.
4. Subacromial decompression (optional): If there is evidence of impingement, the surgeon may smooth the bone or remove inflamed tissue to create more space around the tendon.

What is recovery like?

Arthroscopic surgery for calcific tendonitis is often done as a day case under general anaesthetic.

• Immediate post-op: The arm may be placed in a sling for a short period to allow healing.
• Pain relief: Mild to moderate discomfort is common and managed with painkillers.
• Physiotherapy: Rehabilitation starts early and focuses on restoring movement and strength.
• Full recovery: Most patients regain full function within three to six months, although this may vary depending on tendon repair.

Are there any risks?

As with any surgery, there are risks such as infection, bleeding, stiffness or incomplete pain relief. However, complications are uncommon, and the procedure is generally very safe when performed by an experienced shoulder surgeon.

Surgery for shoulder calcific tendonitis is highly effective when conservative treatments fail, helping to relieve pain and restore normal shoulder use. Patients should discuss all available options with a shoulder specialist to determine the most appropriate treatment based on their symptoms and lifestyle.