A lime shoulder (Tendinosis calcera) is treated surgically if all conservative therapies, such as the use of drugs (pain relievers, anti-inflammatory drugs or cortisone injections) and physiotherapy, have not responded.
Also read our article on that Lime shoulder!
An operation to treat a calcified shoulder is a relatively minor procedure, also known as arthroscopic removal of calcium deposits is marked on the shoulder. Usually the calcium deposits in the tissue of the shoulder vision are removed in a minimally invasive manner. An endoscope with a camera and special surgical instruments are inserted into the shoulder joint through small incisions in the skin. With the help of the camera, the surgeon locates the visible calcium deposits and removes them with a sharp spoon. The wound is then rinsed thoroughly to remove even small calcium particles from the joint. The removal of the calcium creates a notch in the tendon that heals on its own. The advantage of a minimally invasive operation is that the procedure only creates small wounds, which means that the risk of infection is low. In addition, the wounds heal quickly and the joint can be moved again after a short time.
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In severe cases in which a minimally invasive removal of the calcium deposits is not possible, the calcareous shoulder must be operated on conventionally. The skin and the layers of fat and muscle underneath are opened through a cut several centimeters long. After the calcium deposit has been removed, the wound is sutured again. The operation takes a maximum of 45 minutes, is performed under general or local anesthesia and can be performed on an outpatient or inpatient basis.
General anesthesia is not absolutely necessary for the operation of a calcareous shoulder. Many clinics also have a so-called interscalene plexus block in which only the nerves of the diseased shoulder are specifically numbed. Local anesthetics are injected into the arm nerve plexus. This procedure is a relatively simple procedure that involves few risks. Ultimately, the surgeon decides which type of anesthesia is best used and discusses it with the patient in an informative discussion before the operation.
$config[ads_text2] not foundFind out more about the different anesthetic procedures in our article Anesthetic procedures - which ones are there?
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
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Like any surgical procedure, the operation of a calcareous shoulder is associated with certain risks. In contrast to other operations, however, this is a minor intervention and the risks are accordingly low.
The procedure may cause bruises on the shoulder that was operated on (Hematomas) and pain comes. Rarely, a blood clot (thrombosis) forms that is carried away with the bloodstream and e.g. a blocked vessel in the lungs (embolism). Theoretically, bleeding can also occur during the operation, but since there are no large vessels or important nerves in the operated region, this is rather unlikely. Small vessels are closed directly by electric current during the treatment ("chewed up“).
$config[ads_text2] not foundIn less than one percent of cases, germs can get into the wound through the operation and lead to inflammation and wound healing disorders. Signs of wound infection include increasing pain and possibly a fever that does not appear until several days after the surgery. The wound swells, becomes warm, and is very reddened. Since an arthroscopic removal of calcium deposits on the shoulder is usually carried out in a minimally invasive manner, the risk of wound infection is extremely low.
In general, it can be said that this operation is a routine procedure that is relatively low-risk and causes little pain. For more information on postoperative risks, see our article Postoperative Risks - Which Are There?
Are you interested in the wound healing process? Then read our article Phases of wound healing!
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In the so-called postoperative phase directly after the operation, the patient is brought to the recovery room. Newly operated patients wake up from anesthesia under constant monitoring of their vital signs (pulse, blood pressure and breathing).
After the procedure, the wound needs to be cooled at regular intervals. The cooling causes the vessels to contract and the swelling of the surrounding tissue is promoted. The procedure can result in more or less severe pain, so an important part of the follow-up treatment is the use of painkillers (e.g. Ibuprofen). The dressing is changed regularly until the sutures can finally be removed after 10 to 12 days. As long as the sutures have not yet been pulled, the patient must take care of himself. After that, however, the arm can and should be moved directly and immobilization is not necessary.
Physiotherapy and physiotherapy help mobilize the shoulder and thus improve mobility. Regular movement of the shoulder promotes the healing of the wound and prevents new calcium deposits from forming.
Read more on this topic: Exercises after surgery on a calcified shoulder
Usually the pain after the operation is much less than the pain that was caused by the calcified shoulder before the procedure. The arthroscopic removal of calcium deposits is a relatively small procedure in which only two to three small incisions are made. As a result, the resulting injuries are minor and the wounds heal quickly.
Immediately after the procedure there is a clear improvement in the symptoms, only the small surgical wounds still cause pain. Cooling with ice packs and cooling pads relieves pain and prevents excessive swelling of the wound. In addition, patients receive oral pain therapy with anti-inflammatory drugs (e.g. Ibuprofen 3 x 600 mg per day or Diclofenac 2 x 75 mg per day).
You can read in our article how you can adequately counteract the swelling after the operation Swelling after surgery - tips for treatment.
After the calcium deposits in the shoulder have been removed using minimally invasive shoulder arthroscopy, the patients remain in the hospital for one to two days. The shoulder must then be immobilized until the sutures are pulled. Until then, the mobility in the shoulder joint is significantly reduced and the patients need help with everyday tasks and around the house. After about three weeks the wound should be completely healed and the patient can put weight on the shoulder again.
$config[ads_text1] not foundThe length of the sick leave essentially depends on the occupation the patient has. Office patients are on sick leave for about two to four weeks, whereas those who have to do heavy physical work are unable to work for longer. In such cases, the patient can be given sick leave for up to two months after a calcified shoulder operation. It then makes sense for the person concerned to gradually return to work and not immediately return to full-time work.
The operation of a calcareous shoulder removes all calcium deposits and the shoulder is considered to have healed and the calcium deposits are unlikely to recur. After the procedure, the shoulder must be spared for three weeks, with gentle mobilization at the same time through physiotherapy. The operated shoulder tendon usually heals without any problems and the wound healing is complete after three weeks.
In some cases, the calcium deposits spontaneously dissolve and the symptoms disappear. However, a calcareous shoulder causes quite a lot of pain, which is why those affected should not delay treatment for long. Normally, a calcareous shoulder is treated conservatively, i.e. non-operatively. Only if these measures do not help, the shoulder will be operated on.
First, the doctor will prescribe pain relievers and anti-inflammatory drugs to help fight inflammation in the shoulder. If the pain is very severe, cortisone injections, which the doctor injects directly into the bursa of the joint, can also be given. Cortisone has an anti-inflammatory effect and can significantly improve the acute pain of a calcareous shoulder. Frequent injections, however, weaken the tendons and can lead to tendon rupture.
Subsequent exercise therapy is suitable to loosen the calcifications in the tendon. Through physiotherapy and physiotherapy, specific exercises are carried out that have a pain-relieving effect and mobilize the shoulder. In addition, the movement promotes blood circulation and the calcium deposits can be transported away more easily.
Shock wave therapy is another alternative to surgery and has proven to be very effective. The calcified shoulder is treated with high-energy ultrasonic waves, which lead to the destruction of the calcium deposits. The crushed lime residue can then be broken down by the surrounding tissue.
As a rule, all calcium deposits in the shoulder are removed by an operation and the risk of relapse is low. A short time after the operation, the pain can intensify again, as the calcium residue released during the operation is dissolved by the body and this process is usually accompanied by inflammation.
For more information on inflammation in the shoulder, see our article on Inflammation in the shoulder.
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