Rotator Cuff Debridement Compared with Rotator Cuff Repair in Arthroscopic Treatment of Calcifying Tendinitis of the Shoulder: A Systematic Review and Meta-Analysis

Calcifying tendinopathy (CT) of the shoulder is a condition where calcium deposits form in the rotator cuff tendons, leading to pain and limited shoulder function. While conservative treatments have high success rates, some patients may require arthroscopic removal of the calcific deposit. The question of whether to repair the remaining rotator cuff defect after debridement is still controversial and needs to be investigated for functional outcomes. The aim of this study was to compare rotator cuff debridement repair with rotator cuff repair in arthroscopic treatment of CT of the shoulder. MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched from inception to February 2023 for studies on CT Arthroscopic treatment. Patients functional results using the Visual Analogue Scale (VAS), American Shoulder and Elbow Surgeons (ASES), University of California Los Angeles (UCLA) and Constant score were collected. The effect size (ES) was calculated using Cohen´s d index. Twenty-one studies were included, involving a total of 1172 patients aged between 44.7 and 55 years. The mean follow-up time was 24.7 months. The pooled effect size estimates for VAS, ASES, UCLA and Constant total score were very strong (>1.0) for both debridement and debridement combined with suture. The pooled proportion estimates for the number of total complications were 1.75 % (95% CI: 0.08-3.43, I2 = 0%) for debridement and 9.07 %(95% CI: -0.03 -18.17, I2 = 50.4%) for debridement combined with suture. Both arthroscopic procedures, rotator cuff debridement, and debridement combined with suture, resulted in significant improvements in functional outcomes (VAS, ASES, UCLA, and Constant scores) for patients with calcifying tendinitis of the shoulder. However, it was noted that a higher proportion of complications occurred in the group that underwent suture repair. This raises the question of whether it is necessary to repair all partial ruptures after the removal of calcific deposits.