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Arthroscopic acromioclavicular joint resection

An anatomical study

Baylor College of Medicine, Division of Orthopedic Surgery, Houston, Texas

Andrew H. Combs, MD

Baylor College of Medicine, Division of Orthopedic Surgery, Houston, Texas

Pamela F. Davis, MD

Baylor College of Medicine, Division of Orthopedic Surgery, Houston, Texas

Hugh S. Tullos, MD

Baylor College of Medicine, Division of Orthopedic Surgery, Houston, Texas

Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conven tional open surgical technique involves deltoid detach ment and reattachment, which may cause postopera tive weakness and requires protection during the post operative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical ad vantages of no deltoid disruption and a shorter rehabil itation period. The purpose of this study was to com pare open versus arthroscopic acromioclavicular joint resection in a laboratory setting.

The goals of acromioclavicular joint resection in this study were to remove 5 mm of the medial acromion and 10 mm of the distal clavicle. Acromioclavicular joint resections were performed on 10 cadaver shoulders (5 open resections and 5 arthroscopic resections). Open resection was successful at 10 of 15 distal clavicle locations and 14 of 15 medial acromial locations. Ar throscopic resection was successful at 14 of 15 distal clavicle locations and 10 of 15 medial acromial loca tions. The combined bone resection averaged 14.8 mm (±1.99 mm) for the open technique and 14.8 mm (± 2.58 mm) for the arthroscopic technique. The combined bone resection was 1.5 cm or more in all of the meas ured locations for the open technique and in 14 of 15 measure locations for the arthroscopic technique. There was no statistically significant difference between the two groups.

In the laboratory setting, acromioclavicular joint re section was performed effectively and predictably with arthroscopic instruments. Arthroscopic bone resection was comparable to open bone resection.

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