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eMedicine Surgery, 2014For patients who demonstrate the most common presentation (ie, arthritic symptoms), treatment should follow the algorithm assigned to patients with OA.
This includes modified activity, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs).
For individuals with acute episodes, who usually present with an enhanced level of pain and disability, arthrocentesis in combination with administration of an intra-articular steroid provides reliable prompt relief.
Limited studies have shown favorable results from diminishing the calcium deposits with ethylene diamine tetraacetic acid (EDTA) treatment.
EDTA strongly binds to divalent cations (including calcium) and has the potential to eliminate them from the affected area.
The role of EDTA in the treatment of chondrocalcinosis will require more extensive investigation because this agent has significant adverse effects.
Ebenbichler et al reported that 47% of patients demonstrated a decrease of at least 50% of the calcification after 6 weeks of treatment.
At 9-month follow-up, 65% of patients presented with at least a 50% reduction of calcification, with nearly half showing complete resolution.
Surgical Therapy Arthroscopic surgery allows debridement of superficial deposits of the calcium pyrophosphate precipitate.
Surgical treatment of OA with debridement, microfracture chondroplasty, radiofrequency chondroplasty, osteochondral transfers, osteotomy, and, ultimately, partial or total joint replacement completes the armamentarium.
Although the impact of crystal deposition on the viability and future performance of the articular cartilage and meniscus is not clear, many surgeons believe that the presence of this precipitate renders the tissues more fragile.