Hello. I am Dr. Dongkyu Lee, an orthopedic specialist. Inquiries about barbotage for calcific tendinitis have been increasing. Patients ask whether it is truly effective, and report being told at other hospitals that the deposit is too hard for anything but surgery, too large for anything but surgery, and so on. Barbotage is internationally recognized, known as 'Ultrasound-guided Barbotage' or 'Ultrasound-guided Lavage,' and is widely performed. Let's look at the research.
A 2019 study compared the outcomes of barbotage, shockwave therapy, and steroid injections for calcific tendinitis. Barbotage showed superior pain reduction compared to shockwave therapy in both short-term and long-term outcomes. It also showed superior functional recovery compared to steroid injections.
In conclusion, barbotage is reported to be significantly more effective than shockwave therapy or steroid injections alone.
This is quite self-evident. The treatment for calcific tendinitis is removing the calcium, so naturally barbotage, which fragments and removes the calcium, would be more effective than anti-inflammatory injections or shockwave alone. Another study shows:
This 2014 study reports that "barbotage is a safe procedure with a very high success rate and low complication risk," and concludes that "while direct comparison with shockwave therapy or arthroscopic calcium removal surgery was not available, based on the study results, barbotage is recommended as the treatment for calcific tendinitis." With over 10 years of experience performing barbotage, I achieve high success rates regardless of calcium size or characteristics. I have custom-made specialized guides and tips for different calcium types. In the early days, calcium removal was sometimes insufficient and results were not always satisfactory, and procedures took longer... Now, with extensive experience, calcium is removed effectively and procedure times have shortened. Here is a case. A 62-year-old female patient came to me with severe shoulder pain. She had already been diagnosed with calcific tendinitis and was recommended surgery. She was afraid of surgery and searched for non-surgical options online, which led her to our clinic.
Barbotage was performed to remove the calcium.
The post-procedure syringes show calcium indicated by the yellow arrows. The leftmost syringe was used first and contains the most calcium, with progressively less in each subsequent syringe. After removing the calcium, an X-ray was taken.
The calcium previously visible in the red circle is nearly invisible in the blue circle. Let's compare the before and after images.
Comparing the two images confirms the calcium has been removed. The patient experienced immediate pain relief and was thrilled that she could move her shoulder again after the procedure.
Calcific tendinitis can be treated with barbotage.
