Calcific Tendinitis Surgery
in Rockhampton

What is going on

Calcific tendinitis is the painful deposition of calcium hydroxyapatite crystals within the substance of a rotator cuff tendon, most commonly the supraspinatus. Patients describe a deep, severe shoulder pain — often disproportionate to anything that might have triggered it — that can wake them at night and limit overhead reach. The pain is at its worst during the resorptive phase, when the body is actively reabsorbing the deposit and the surrounding tissue is highly inflamed. X-rays show a characteristic dense calcium deposit at or near the cuff insertion. The condition is most common in middle age and is more frequent in women than men.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

When surgery is offered, the calcium deposit is excised arthroscopically through several small portals around the shoulder. The cuff is opened over the deposit, the calcium is removed, and the residual cuff defect is repaired in the same way as a routine rotator cuff tear when the cuff has been weakened. The procedure usually takes 60 to 90 minutes under regional and general anaesthesia; patients leave hospital the same or next day. Full clinical detail and the choice between barbotage, injection and surgical excision is on the education page.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the calcific tendinitis education page or the shoulder surgery overview.

How this case is handled

Calcific tendinitis is one of the rare shoulder conditions where surgery is genuinely a last resort — many patients are referred during the resorptive phase when surgery is not yet indicated, and timing matters. The first consult is focused on confirming the diagnosis, structuring the non-operative pathway, and arranging barbotage where appropriate before considering surgical excision. Shoulder physiotherapy through George Labor in the same suite is integrated into the post-operative pathway when surgery is required.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48948 Excision of calcium deposit (calcific tendinitis only)

Used when the calcium is excised but the cuff does not require formal repair

Item 48960 Cuff repair / reconstruction

Used when the cuff is incised and formally repaired in the same arthroscopic operation — the more common scenario, since the cuff is often weakened by the deposit

Patient questions we hear most

• Is surgery actually needed for calcific tendinitis?

  In most cases, no. The natural history of calcific tendinitis is favourable — the deposit is reabsorbed by the body over weeks to months, and the pain settles as the deposit disappears. Conservative measures — anti-inflammatories, physiotherapy, ultrasound-guided barbotage and corticosteroid injection — settle the great majority of cases. Surgery is reserved for patients with severe persistent pain despite a thorough non-operative course; the threshold is genuinely high and most patients never need an operation.

• What is barbotage and is it offered at the practice?

  Barbotage — also called calcium aspiration or needle lavage — is an ultrasound-guided procedure in which a needle is passed into the calcium deposit and the calcium is aspirated or fragmented under ultrasound vision, often combined with a small corticosteroid injection. It is performed by an interventional radiologist rather than the surgical practice, and Dr Hirpara will arrange referral where it is the appropriate next step. Barbotage settles the pain in a substantial proportion of cases without recourse to surgery.

• What's the difference between calcific tendinitis surgery and rotator cuff repair?

  The two operations overlap. Both are arthroscopic procedures focused on the cuff. Where the cuff is intact and only the calcium is excised, the Medicare item is 48948 (excision of calcium deposit). Where the cuff is incised and formally repaired in the same arthroscopic operation — which is the more common scenario, since the cuff is often weakened by the deposit — the item is 48960, the same as a routine cuff repair. The recovery pathway is the same in either case because the surgical exposure and rehabilitation requirements are similar.

• How much does calcific tendinitis surgery cost? What does Medicare cover?

  Surgery for calcific tendinitis is performed under regional and general anaesthesia, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

• Will the calcium come back after surgery?

  True recurrence at the same tendon site after a properly executed excision is uncommon, because the deposit is the focus of the disease and removing it addresses the cause directly. New calcium deposits can occasionally form in adjacent rotator cuff tendons over years in patients with a strong predisposition. Persistent or returning shoulder pain after surgery is investigated carefully; sometimes the calcific tendinitis was masking another shoulder mechanism.

• What's the success rate of surgery for calcific tendinitis?

  Published outcomes consistently show high satisfaction rates after surgical excision of a calcium deposit — the surgery addresses the underlying pathology directly. The best outcomes are in patients with a single dominant deposit, no other shoulder pathology, and a thoroughly trialled non-operative programme. Outcomes are individual and discussed at the consultation.

• Do I need physiotherapy after calcific tendinitis surgery?

  Yes — shoulder physiotherapy is integrated into the post-operative pathway. The schedule mirrors rotator cuff repair: passive range of motion in the first six weeks, active motion from six weeks, strengthening from twelve weeks. Shoulder physiotherapy is provided by George Labor in the same suite as Dr Hirpara's rooms. Patients from outside Rockhampton can usually arrange ongoing therapy closer to home after the early intensive sessions.

More general questions about appointments, fees and the practice on the FAQ page.