Intraoperative localization of calcification in the supraspinatus via a percutaneous marking suture after preoperative ultrasound

T Ambacher, A Kirschniak, U Holz
Journal of Shoulder and Elbow Surgery 2007, 16 (2): 146-9
In a prospective study, we evaluated the efficiency of a technique for localizing calcification via a marking suture. In 27 patients, we measured the distance between the center of the calcification and the long head of the biceps preoperatively. Intraoperatively, we determined the distance detected by ultrasound on the articular side of the cuff under arthroscopic visualization. In this position, a spinal needle was inserted through the supraspinatus tendon. A PDS suture was passed through the spinal needle into the joint. The spinal needle was then removed. The entrance point of the PDS suture into the supraspinatus tendon was localized in the subacromial space after resection of bursal tissue. We perforated the cuff with a spinal needle in this area to definitively detect the calcification. The calcification was pressed out of the cuff with a probe. With this technique, calcification could be removed arthroscopically in all patients. This operative technique led to a reduced operative time, with a mean of 19 minutes.

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