Barbotage - calcification removal at OpenMed Warsaw

Barbotage is a minimally invasive orthopaedic procedure involving the removal of calcifications from soft tissues, most commonly within tendons. The procedure is performed under ultrasound guidance and is mainly used in the treatment of painful calcifications in the shoulder area, particularly in the course of rotator cuff tendinitis. If you are experiencing chronic shoulder pain, restricted movement, or recurring inflammation, we invite you to a consultation at OpenMed in Warsaw. Our specialists will assess the cause of your symptoms and, if indicated, recommend treatment using the barbotage method.

Causes and symptoms of tendon calcifications

Tendon calcifications develop as a result of calcium deposits accumulating within damaged or overloaded tissues. They most commonly affect the supraspinatus tendon in the shoulder but can also occur in other structures of the musculoskeletal system. These deposits can cause chronic inflammation, pain, and restricted range of motion in the joint. In many cases, conservative treatment is initially applied, but when symptoms persist for an extended period, calcification removal is considered.

The exact cause of calcification formation is not always clear-cut. Most commonly, they develop as a result of tendon overloading, microtrauma, and degenerative changes in tissues. The problem can affect both physically active individuals and patients whose work involves repetitive arm movements.

The most common symptoms include:

shoulder pain that worsens when raising the arm or performing overhead movements,
restricted mobility in the shoulder joint,
pain appearing at night or when lying on the affected side,
a feeling of stiffness and weakness in the upper limb.

Symptoms may be chronic or appear suddenly during periods of inflammation exacerbation.

Marta Burbul, MD

Paediatric orthopaedics, Orthopaedics

Calcification diagnostics at OpenMed

Diagnostics begin with an orthopaedic consultation. Our doctors conduct a thorough interview regarding the nature of the pain, duration of symptoms, and previous treatment. This is followed by an orthopaedic examination assessing the range of motion in the shoulder joint and the response to specific functional tests.

An important element of diagnostics is musculoskeletal ultrasound. It allows for precise localisation of calcifications, assessment of their size, and evaluation of the condition of surrounding tendons and bursae. In some cases, the doctor may also recommend an X-ray examination, which facilitates assessment of the degree of tissue calcification.

What does the barbotage procedure involve?

Barbotage is performed under ultrasound guidance, which allows for precise localisation of the calcification and safe execution of the procedure. The procedure involves inserting a thin needle into the area of calcium deposit accumulation. The doctor then washes out the calcifications using a saline solution, breaking them up and removing them from the tissues.

The procedure is performed under local anaesthesia and usually takes around fifteen minutes. Thanks to ultrasound guidance, it is possible to accurately monitor the course of the procedure and minimise the risk of damage to surrounding structures. After the procedure, an anti-inflammatory medication is often administered into the bursa or the area around the tendon to reduce inflammation and accelerate the healing process.

Recovery after barbotage

After the barbotage procedure, the patient can usually return home the same day. Mild pain or tenderness at the procedure site may persist for a few days. In most cases, a short break from intensive activity is recommended, along with rehabilitation to help restore normal range of motion in the joint.

Rehabilitation exercises aim to improve tendon flexibility, strengthen shoulder muscles, and reduce the risk of symptom recurrence. Our specialists at OpenMed monitor the treatment process and modify the therapy plan if needed.

If you are experiencing chronic shoulder pain or suspect calcifications in your tendons, book an orthopaedic consultation at OpenMed Warsaw.

Telephone and online registration - the OpenMed team will help select an appropriate appointment date and plan further diagnostics or treatment.

FAQ - Barbotage Warsaw

: The procedure is performed under local anaesthesia, so most patients experience only minor discomfort.
: The procedure itself usually takes from around fifteen to approximately thirty minutes, depending on the size and location of the calcification.
: In many cases, rehabilitation exercises are recommended to help restore normal range of motion in the joint and prevent symptom recurrence.
: The risk of recurrence exists, however, appropriate rehabilitation and limiting shoulder overloading significantly reduce it.