Arthroscopic removal of arch-shaped rotator cuff calcifying tendinitis without rotator cuff repair and acromioplasty is an excellent treatment regarding pain relief and function.

PURPOSE: The aim of this study is to evaluate clinical outcome for arthroscopic removal of calcium deposit without acromioplasty and rotator cuff repair for patients with ultrasound-diagnosed arch-shaped calcifying tendinitis of the rotator cuff (type I), homogenic (x-ray) with chronic pain. METHODS: We retrospectively reviewed 50 patients with homogenous, arch-shaped calcifying tendinitis, suffering from chronic pain and who underwent arthroscopic treatment and 50 patients with the same type of tendinitis treated conservatively. All patients had calcium deposit located in supraspinatus tendon, pre-operatively and post-operatively evaluated by ultrasound. Clinical outcome was assessed by using Quick DASH, UCLA, and VAS score. RESULTS: There were 29 male and 71 female patients; none had bilateral involvement. We divided patients into group A-operatively treated-and group B-conservatively treated-by shock wave therapy. Patients from group A had higher improvement of all used tests, QDash (from 19.3 to 2.7), UCLA (from 10 to 34), and VAS score (from 3 to 0) when compared with group B. CONCLUSION: Patients with arch-shaped calcium deposits and acoustic shadow have better results after arthroscopic treatment than the conservative one. There was no need for acromioplasty or tendon repair. The lack of performing the same did not have any impact on the post-operative rehabilitation and recovery.

Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae.

PURPOSE: The purpose of this study was to evaluate functional outcomes of reverse shoulder arthroplasty (RSA) in patients with acute fracture and sequelae of the proximal humeral fractures. METHODS: Thirty-seven patients were treated with RSA for acute fracture and sequelae of a proximal humeral fracture. The average age was 73 years (range 50-87 years). Twenty-one patients had had no previous surgery, seven patients had acute fractures and 14 patients had chronic fractures. Sixteen patients had had previous surgery. Active range of motion and Constant score were evaluated at a minimum follow-up of two years. RESULTS: Active elevation was 102°, external rotation 24°, and internal rotation was up to L4 in all patients. In the group of patients without previous surgery treated with RSA, elevation was 116°, external rotation 24°, and internal rotation up to L3. In the group of patients with previous surgery treated with RSA, elevation was 84°, external rotation 19°, and internal rotation up to L4. In the group of patients with acute fracture treated with RSA, elevation was 124°, external rotation 28°, and internal rotation up to L4. In the group of patients with chronic or sequel of the fractures treated with RSA elevation was 114° , external rotation 28°, and internal rotation up to L3. Constant score in all patients was 54. Constant score in patients without previous surgery treated with RSA was 68 and with previous surgery it was 42. CONCLUSION: Patients without previous surgery treated with RSA for fractures had better functional results than patients who had undergone previous surgery.

Endoscopic treatment of the external snapping hip syndrome: surgical technique and report of two cases.

Snapping hip or coxa saltans is a condition characterized by an audible and/or palpable snapping during hip movement and can be associated with pain around the hip. There are various causes of this condition and can be divided into two types: extra-articular and intra-articular. The most common type is the external extra-articular, where the snapping is due to thickened posterior part of the iliotibial band or anterior part of the gluteus maximus muscle sliding over the greater trochanter during hip movement. Two patients with external snapping hip are presented, who were treated with our original endoscopic iliotibial band release and greater trochanteric bursectomy. There were no surgical complications and the patients did not experience snapping or pain in the hip during 24-month follow-up period. Results of various open techniques and one endoscopic technique in the treatment of external snapping hip are also reported.