Posterior Rotator Cuff Tear Following Extracorporeal Shock Wave Therapy for Posterior Calcific Tendinitis: A Case Report

A 47-year-old female patient presented with left shoulder pain lasting more than 6 months and was diagnosed with posterior calcific tendinitis and a partial-thickness rotator cuff tear.She had undergone six sessions of extracorporeal shock wave therapy (ESWT) over a period of 6 weeks, with treatments administered at weekly intervals.The therapy was performed using medium-energy focused shock waves (0.15-0.20 mJ/mm 2 ), and the last session was completed approximately 2 weeks prior to her presentation.Imaging revealed a 1 cm calcific deposit near the teres minor and a 1.5 cm bursal-side tear of the posterior supraspinatus, accompanied by infraspinatus muscle atrophy.Arthroscopic surgery was performed to remove the calcific deposit and repair the rotator cuff using a suture bridge technique.Due to poor tendon quality, an acellular dermal matrix (ADM) graft was used for biological augmentation.The patient followed a structured rehabilitation protocol.At 1-year follow-up, she demonstrated full range of motion, an American Shoulder and Elbow Surgeons score of 88, and no evidence of calcification recurrence or tendon retear.This case highlights the potential for tendon injury after ESWT and the utility of ADM in augmenting compromised rotator cuff tissue.