Calcific Tendinitis Surgery (Barbotage / Arthroscopic Removal)

⚙️What This Procedure Involves

Barbotage: performed in clinic or radiology under ultrasound guidance. Two needles are inserted into the calcium deposit — one to break up and aspirate the calcium, the other to irrigate. Corticosteroid is injected after aspiration. Takes 20–30 minutes. Arthroscopic: performed in theatre through small incisions. The calcium deposit is located within the rotator cuff tendon, incised, and curetted out. Subacromial decompression may be performed at the same time. Takes 30–60 minutes.

💡Why It May Be Recommended

Surgery or barbotage is considered for calcific tendinitis causing severe pain that has not responded to physiotherapy, anti-inflammatory medication, and corticosteroid injection. Many calcium deposits resolve spontaneously over months to years.

⚖️Non-Operative Alternatives

Physiotherapy, oral anti-inflammatory medication, subacromial corticosteroid injection, extracorporeal shockwave therapy (ESWT), and observation (many resolve spontaneously).

📋Preparing for Surgery

X-ray or ultrasound confirming the calcium deposit. Assessment of deposit size and consistency. Day-case procedure.

✅Expected Benefits

Pain relief in approximately 85–90% of patients. Complete resolution of the calcium deposit. Most patients experience significant improvement.

⚠️Common Risks

• Post-procedure flareCommon

  Intense pain for 24–72 hours after barbotage or surgery as the calcium is resorbed.

• Incomplete removalUncommon

  Some calcium may remain.

• Shoulder stiffnessCommon

  Temporary.

🔴Less Common but Serious Risks

• Rotator cuff tearUncommon

  Removing calcium weakens the tendon. Small tears may occur.

• RecurrenceRare

  Calcium may reform, though this is uncommon after successful removal.

• Frozen shoulderUncommon

  Post-procedural stiffness.

• InfectionRare

  Joint infection (arthroscopic) or needle site infection (barbotage).

💉Anaesthetic Considerations

Barbotage: local anaesthetic with ultrasound guidance. Arthroscopic: general anaesthesia with nerve block.

🏃Recovery and Rehabilitation

Barbotage: immediate recovery, though a post-procedure pain flare is common for two to three days. Arthroscopic: sling for one to two weeks, physiotherapy from one week. Full recovery four to eight weeks.

📅Follow-Up

X-ray at six weeks to confirm deposit resolution. Review at six weeks.

❓Frequently Asked Questions