title: Arthroscopic resection of the distal clavicle with a superior approach.
abstract: Forty-one patients (41 shoulders) with acromioclavicular joint disease refractory to conservative treatment underwent arthroscopic distal clavicle resection. Thirty-one men and 10 women with an average age of 32 years were studied. The dominant extremity was involved in 68% of the patients. At an average follow-up period of 31 months (range 24 to 49 months), 18 excellent, 16 good, and seven poor results were found. Twenty-seven (93%) of 29 shoulders with acromioclavicular arthritis or osteolysis of the distal clavicle went on to have satisfactory results compared with only seven (58%) of 12 shoulders with previous grade II acromioclavicular separations or acromioclavicular hypermobility. Total amount of bone removal did not correlate with success, if the resection was even. Five reoperations were done; one uneven resection was revised with arthroscopy, and four shoulders underwent acromioclavicular stabilization procedures. The high failure rate in patients with even subtle acromioclavicular instability (42%) suggests that in these cases formal stabilization with ligament reconstruction should be considered in addition to resection of the distal clavicle.
authors.affiliation: Shoulder Service, New York Orthopaedic Hospital, Columbia Presbyterian Medical Center, New York, NY.
authors.forename: E L
authors.initials: EL
authors.lastname: Flatow
authors.forename: X A
authors.initials: XA
authors.lastname: Duralde
authors.forename: G P
authors.initials: GP
authors.lastname: Nicholson
authors.forename: R G
authors.initials: RG
authors.lastname: Pollock
authors.forename: L U
authors.initials: LU
authors.lastname: Bigliani
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D020679:Arthroscopes; D001182:Arthroscopy / Q000379:methods; D002968:Clavicle / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome