Barbotage offers a minimally invasive solution for patients suffering from chronic calcific tendonitis. Guided by high-resolution ultrasound, we direct a small needle to the precise location of the calcium deposit and perform a targeted lavage to fragment and aspirate hydroxyapatite crystals directly from the affected tendon. This “wash out” technique minimizes trauma to surrounding tissue and triggers your body’s natural healing response for long-term recovery.
Diagnostic Process: Align exam findings with imaging to pinpoint and characterize the exact size, location, and consistency of the calcium deposit.
Local Anesthesia: The procedure is performed under local anesthesia, numbing the treatment site completely. This eliminates the need for general sedation and allows for a quicker, easier recovery.
Needle Lavage (Barbotage): This minimally invasive procedure uses a fine needle and sterile saline to gently break up and ‘wash out’ calcium deposits, directly relieving pain and inflammation.
Bursal Injection: We inject a solution of local anesthetic and corticosteroid to the overlying bursa to minimize post-procedural pain and inflammation, promoting optimal recovery.
Post‑Treatment Plan: Our recovery protocol involves a short rest period followed by a tailored rehabilitation program to safely rebuild strength and movement.
Rotator cuff calcific tendinopathy. This typically affects the supraspinatus or infraspinatus tendons and is often accompanied by subacromial bursitis, caused by irritation from the calcium deposits.
Calcific tendinopathy in the side (gluteus medius/minimus) and front (rectus femoris) of the hip.
Calcific tendinopathy involving the patellar and quadricepts tendons.
While most common in the Achilles, calcific tendinopathy can also occur in the peroneal and tibialis posterior tendons.
Calcific tendinopathy of the elbow—including Tennis Elbow, Golfer’s Elbow, and triceps injuries. Though less common, this condition can also affect tendons at the wrist.
Visit length
30–45 minutes. This is an outpatient procedure; you will return home the same day.
Sensation
You may feel pressure or brief discomfort despite local anesthesia; most describe it as very tolerable.
Post-Treatment Recovery
Expect soreness for the first 2–3 days, with mild achiness potentially lasting a week. Manage discomfort with ice, heat, or acetaminophen; if you prefer an anti-inflammatory (NSAID), please check with your clinician first.
Activity Protocol
Light daily tasks and gentle stretching immediately. Avoid heavy lifting or high-impact activities for the first two weeks; after this period, you may progress to your guided exercise program.
Results
Most patients experience significant pain relief within 7-14 days. Improvement typically continues over a 4–8 week period as the calcium deposit naturally resorbs. In persistent cases, we may recommend a Tenex debridement or Platelet-Rich Plasma (PRP) therapy to further stimulate and accelerate tendon healing.
Safety
This is a very safe procedure due to its ultrasound-guided, needle-based approach. Minor side effects like bruising, transient pain, or vasovagal responses may occur, serious complications—including infection or nerve and tendon injury—are rare.
We’ll review your history, imaging, goals, and prior treatments to determine whether barbotage is the most appropriate procedure for your condition.
What to know more about our evidence based approach? Explore the links below for more information.
We deliver nonsurgical orthopedic treatments, advanced diagnostics, and personalized recovery plans that restore function and optimize performance.
We deliver nonsurgical orthopedic treatments, advanced diagnostics, and personalized recovery plans that restore function and optimize performance.
We deliver nonsurgical orthopedic treatments, advanced diagnostics, and personalized recovery plans that restore function and optimize performance.
We deliver nonsurgical orthopedic treatments, advanced diagnostics, and personalized recovery plans that restore function and optimize performance.
Schedule a consultation to explore non-surgical treatment options that align with your active lifestyle.
