From the Research
Barbotage is a therapeutic procedure that involves the injection of air or gas into a body cavity, specifically used to treat calcific tendinopathy, particularly in the shoulder, by breaking up and removing calcium deposits using ultrasound guidance and saline solution injection and aspiration. This procedure is performed under local anesthesia and typically takes 15-30 minutes. The goal of barbotage is to stimulate the resorption process of the calcium deposits, which can lead to significant pain relief and improvement in shoulder function and quality of life 1.
Procedure Details
The procedure involves inserting a needle into the calcification under ultrasound guidance, and then injecting and aspirating saline solution multiple times to create a washing effect that fragments and dissolves the calcium. After breaking up the deposit, corticosteroids are often injected to reduce inflammation and pain. Patients may experience temporary increased pain for 24-48 hours after the procedure, which can be managed with ice and over-the-counter pain medications.
Efficacy and Outcomes
Barbotage has been shown to be an effective treatment option for calcific tendinopathy, with significant pain relief and improvement in shoulder function and quality of life reported in several studies 1, 2. The procedure is minimally invasive and offers an alternative to surgery for patients with persistent calcific tendinopathy that hasn't responded to conservative treatments. Good candidates for barbotage are those with rotator cuff calcific tendinitis who have ≥1 large calcific deposit.
Key Points
- Barbotage is a therapeutic procedure used to treat calcific tendinopathy, particularly in the shoulder.
- The procedure involves using ultrasound guidance to repeatedly inject and withdraw fluid into a calcium deposit to break it up and remove it.
- Barbotage is effective because it directly addresses the cause of pain by physically removing the calcium deposit rather than just treating symptoms.
- Most patients experience significant pain relief within 2-4 weeks, though complete resolution of symptoms may take longer.
- The procedure is minimally invasive and offers an alternative to surgery for patients with persistent calcific tendinopathy that hasn't responded to conservative treatments.