title: Outcome of distal clavicle resection in patients with acromioclavicular joint osteoarthritis and full-thickness rotator cuff tear.
abstract: OBJECTIVE
  The purpose of this study was to examine the impact of distal clavicle resection (DCR) on subjective and objective outcome measures in patients with acromioclavicular (AC) joint osteoarthritis (OA) and rotator cuff tear.
  
  
  METHODS
  Prospectively collected data of consecutive patients with arthroscopic evidence of OA of the ACJ with complete data at 2 years were used for the data analysis. Patients with moderate-to-severe OA of the AC joint underwent a DCR in conjunction with rotator cuff repair, while patients with mild OA of the ACJ underwent surgery related to concomitant rotator cuff tear without a DCR.
  
  
  RESULTS
  Data of 184 (72 females, 112 males, mean age: 62) patients with rotator cuff tear and varying degrees of OA of the AC joint were used for the analysis. Of 184 patients, 144 (78 %) had a resection of distal clavicle (resection group) and 40 (22 %) did not have a resection (no-resection group). Both groups showed a statistically significant (p < 0.0001) improvement in the American Shoulder and Elbow Surgeons (ASES) scores, Constant Murley score, and strength. Multivariable analysis showed that lower pre-operative ASES scores (higher disability), having a larger tear, an active compensation claim, and not having a DCR, had a negative impact on post-operative ASES scores.
  
  
  CONCLUSIONS
  When untreated surgically, even mild arthroscopic findings of AC joint OA may lead to a poorer outcome after rotator cuff repair. Further characterisation of patients in whom mild arthroscopic findings of OA of AC joint are clinically significant and warrant resection is needed.
  
  
  METHODS
  Retrospective outcome study, Level II.
authors.affiliation: Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, helen.razmjou@sunnybrook.ca.
authors.forename: Helen
authors.initials: H
authors.lastname: Razmjou
authors.forename: Amr
authors.initials: A
authors.lastname: ElMaraghy
authors.forename: Tim
authors.initials: T
authors.lastname: Dwyer
authors.forename: Simon
authors.initials: S
authors.lastname: Fournier-Gosselin
authors.forename: Moira
authors.initials: M
authors.lastname: Devereaux
authors.forename: Richard
authors.initials: R
authors.lastname: Holtby
mesh_terms: D000173:Acromioclavicular Joint / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D002968:Clavicle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome