Calcific tendonitis is a condition where hard, chalk-like calcium deposits form within a tendon, most commonly in the rotator cuff of the shoulder. This abnormal accumulation can cause inflammation and significant pain. Surgery is typically reserved for cases where non-operative treatments, such as physical therapy, injections, or medication, have failed to relieve symptoms. Understanding the surgical timeline involves much more than just the minutes spent in the operating room; it includes the entire process from hospital check-in to long-term recovery.
The Surgical Procedure and Operating Room Duration
The actual time a patient spends in the operating room for calcific tendonitis excision is relatively short, often ranging from 30 to 60 minutes. The procedure is usually performed using an arthroscopic approach, which involves making several small incisions, typically about one centimeter long, around the shoulder. Through these small openings, a surgeon uses a tiny camera, or arthroscope, to visualize the joint and specialized instruments to remove the calcium deposit from the affected tendon.
The duration is influenced by factors such as the size and location of the calcium deposit and whether additional procedures are necessary. If the surgeon must also repair a small hole in the tendon or perform a subacromial decompression, the total surgical time will increase. Arthroscopy is generally favored over open surgery because it is less invasive, leading to minimal blood loss and a quicker initial recovery.
The time range quoted represents only the period the patient is under anesthesia and the surgical team is actively operating. Patients usually receive a combination of general anesthesia and a regional nerve block to numb the arm for post-operative pain control. This nerve block can last anywhere from 12 to 24 hours, which significantly impacts the patient’s immediate post-operative experience.
Pre-Operative Preparation and Immediate Post-Procedure Stay
The operating time is a small fraction of the total time spent at the surgical facility. The pre-operative phase begins upon arrival and involves checking in, signing consent forms, and meeting the surgical and anesthesia teams. A nurse will start an intravenous (IV) line and ensure the patient is comfortable before the procedure begins.
This preparation period can take between one to two hours before the patient is moved into the operating room. Once the procedure is complete, the patient is moved to the Post-Anesthesia Care Unit (PACU) where they are closely monitored as they wake up from general anesthesia. This immediate post-operative observation period is variable, depending on how quickly the patient recovers from the anesthesia and how well their pain is managed.
Patients are typically discharged as a same-day, outpatient procedure, provided there are no complications and they meet specific discharge criteria. The total time from hospital arrival to being released to go home is generally between three to five hours. A patient must have a responsible adult available to drive them home and stay with them, as the effects of anesthesia and the nerve block will temporarily impair their ability to function independently.
Expected Recovery Milestones and Timeline
The full recovery following calcific tendonitis surgery extends well beyond the day of the operation, often spanning several months. Initially, the arm is placed in a sling, which may be worn for the first one to four weeks, depending on the extent of the repair. During this time, the focus is on managing swelling and pain, often with prescribed medication and ice.
Physical Therapy and Motion
Physical therapy is a fundamental component of the recovery process, often beginning with gentle, passive range-of-motion exercises within the first few days or weeks. Passive motion means the therapist or the patient’s other arm moves the surgical arm, protecting the healing tendon. The initiation of active motion, where the patient uses their own muscles to move the arm, usually starts around four to six weeks post-surgery.
Return to Activity
Returning to light daily activities, such as driving, can often occur around two to six weeks, once the sling is discontinued and sufficient arm control is regained. Strengthening exercises typically begin between six and twelve weeks after the operation. Most individuals can return to non-strenuous work within a few weeks, but full recovery and a return to heavy lifting or strenuous overhead sports activities typically requires three to six months. Adherence to the physical therapy protocol is essential for a successful outcome.