title: Comparison between open and arthroscopic procedures for lateral clavicle resection.
abstract: OBJECTIVE
  Arthroscopic lateral clavicle resection (LCR) is increasingly used, compared to an open approach, but literature does not clearly indicate which approach is preferable. The goal of this study was to compare function and pain between patients who underwent lateral clavicle resection using an open approach and patients treated using an arthroscopic approach.
  
  
  METHODS
  Patients who underwent LCR between January 2008 and December 2011 were reviewed. After exclusion, 149 shoulders (143 patients) were eligible for analysis: 41 open and 108 arthroscopic. Disabilities of arm, shoulder and hand (DASH) questionnaire and visual analogue scale (VAS) score were used to assess shoulder function and pain. Complications, operative time, length of hospitalization and resection distance were compared.
  
  
  RESULTS
  At a mean follow-up of three years, patients in the open group had significantly less pain by VAS (mm) (Mdn 10, IQR 23) compared with arthroscopic patients (Mdn 20, IQR 50) (p = 0.036). Operative time (minutes) was significantly less for the open approach (Mdn 24.0, IQR 12) compared with arthroscopic (Mdn 38.0, IQR 15) (p < 0.001). Resection distance (mm) was larger for the open approach (Mdn 7.1, IQR 7.0) compared with the arthroscopic approach (Mdn 3.2, IQR 3.1) (p = 0.006), but was not associated with outcome. No significant differences were found for DASH score, complication rate or length of hospitalization.
  
  
  CONCLUSIONS
  Both arthroscopic and open approaches for LCR provide excellent outcome in patients with acromioclavicular pain. Less residual pain was found for the open approach, which has shorter operating time and is likely more cost effective.
authors.affiliation: CORAL - Center for Orthopaedic Research Alkmaar, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
authors.forename: Nick
authors.initials: N
authors.lastname: Duindam
authors.forename: Jesse W P
authors.initials: JW
authors.lastname: Kuiper
authors.forename: Marco J M
authors.initials: MJ
authors.lastname: Hoozemans
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Burger
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002968:Clavicle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome