Review Article

Therapeutic options in rotator cuff calcific tendinopathy

¹ Department of Orthopedic Surgery, Hospital Británico de Buenos Aires, C1280 AEB, Argentina
² Manchester University NHS Foundation Trust, Manchester M13 9WL, United Kindom
³ Shoulder Planet Clínica Ortopédica, São Paulo 01258-010, Brazil
⁴ Department of Orthopedic Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
⁵ SportsMe Medical Center, Seville 41013, Spain

^* Corresponding author: drdanielmoya@yahoo.com.ar

Received: 20 July 2024
Accepted: 26 January 2025

Abstract

There are many variables that influence the decision-making process in the treatment of rotator cuff calcifications. The stage of the deposit, prognostic factors, previous failed treatments, pain level, and functional disability must all be considered. The tendency for spontaneous resolution is an important reason to always exhaust conservative treatment, being non-invasive options the first line of treatment. The emergence of focused shock wave therapy offered a powerful tool for the non-invasive management of rotator cuff calcifications. High-energy focused shock waves have a high degree of recommendation for the treatment of rotator cuff calcifications, supported by meta-analyses and systematic reviews. If non-invasive techniques fail, there is the possibility of moving to a minimally invasive procedure such as ultrasound-guided barbotage. Finally, classic invasive techniques are also a frequent indication, including open surgery and arthroscopy. As each treatment has advantages and disadvantages, the most advisable strategy is to progress from the least invasive therapeutic methods to the most invasive ones without losing sight of the clinical stage of the disease and the general context of each patient.