Calcific Supraspinatus Tendonosis

Video Transcription

0:00 This is an arthroscopic DVD of arthroscopic treatment of Calcific Suprastinatus Tendonitis in the right shoulder. Here we are viewing the subacromial space from the posterolateral portal. The rotated cuff is below us, and a small needle is being introduced through the cuff. Here you can see the needle being introduced into the cuff, and the bursal surface is being breached to allow the contents of the calcific deposit within supraspinatus to be more clearly viewed. Extremely easily, the contents of this calcific deposit are removed. The calcific deposit itself has a rather cheesy or toothpaste type appearance and texture.
1:14 Now an arthoscopic hook is being used, again through the anterolateral portal, to gently tease out the calcific deposit. As we are doing this, the debris that is coming out of the lesion is being evacuated. It’s important not to damage the rotated cuff as one is removing the cacific deposit.
1:58 Now, a beveled suction device has been introduced into the cuff, which allows all the evacuated material to be sucked out through the canulla. Also surrounding synovitic tissue, which has been aggravated by the calcific deposit, is also removed. The suction device is now being inserted into the cavity of the calcific deposit to try and remove as much of the calcific deposit without damaging the surrounding cuff. The large defect that was there will eventually heal with new tendonous tissue. A small curette is now introduced into the remnants of the calcific deposit to tease out any residual calcific elements. This is to ensure complete evacuation of the deposit.
4:20 Finally, a soft-tissue resector is introduced into the subacromial space to remove any loose and unstable elements of top surface of the cuff as you can see. This creates a nice smooth articulating surface on the top surface of supraspinatus.

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