Gärtner Type and Outcomes After US PAL Versus Arthroscopic Debridement for Calcific Tendinitis: A Retrospective Cohort Study.
In Gärtner Type I calcification, arthroscopic debridement was associated with better shoulder function than aspiration-lavage.
Gärtner Type and Outcomes After US PAL Versus Arthroscopic Debridement for Calcific Tendinitis: A Retrospective Cohort Study.
To compare the efficacy of US-PAL and arthroscopic debridement for calcific tendinitis stratified by Gärtner type, addressing whether calcification morphology influences treatment response-a question prior randomized trials were not designed to answer.
This retrospective cohort study analyzed 72 patients with refractory calcific tendinitis who underwent either ultrasound-guided percutaneous aspiration and lavage (US-PAL) or arthroscopic debridement (arthroscopic debridement) between June 2022 and June 2024.
Higher American Shoulder and Elbow Surgeons shoulder-function score with debridement than aspiration-lavage, exceeding the clinically important difference.
Both groups demonstrated significant improvement from baseline to 12 months across all outcome measures (all P < .001).
A significant treatment-by-Gärtner-type interaction was observed (coefficient = 16.85; 95% CI: 9.92-23.79; P < .001).
In Gärtner Type II calcifications, no significant between-group differences were detected (all P > .05), and all differences remained below minimal clinically important difference thresholds.
US-PAL was associated with shorter operative time and lower cost (P < .05).
The Gärtner classification was associated with differential treatment outcomes in this retrospective cohort.
For Type II calcifications, US-PAL demonstrated non-inferior efficacy to arthroscopic debridement, with shorter operative time and lower cost.
For Type I calcifications, arthroscopic debridement was associated with superior functional improvement.
These findings suggest that this imaging-based classification may assist in treatment selection, although prospective validation is required.