Effectiveness of arthroscopic distal clavicle resection for symptomatic acromioclavicular joint arthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Qingjun ¹ , LU Wenqian ² ,  YOU Tian ³ , ZHANG Xintao ³ , ZHANG Wentao ³ , LI Canfeng ³

1. Weifang Medical University, Weifang Shandong, 261000, P. R. China;
2. Shenzhen University, Shenzhen Guangdong, 518000, P. R. China;
3. Department of Sports Medicine, Peking University Shenzhen Hospital, Shenzhen Guangdong, 518000, P. R. China;

Corresponding author：

YOU Tian, Email: 17914@163.com

Keywords：

Acromioclavicular joint; arthroscopic surgery; distal clavicle resection; arthritis

DOI：

10.7507/1002-1892.202201088

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Objective To investigate the effectiveness of arthroscopic distal clavicle resection for the symptomatic acromioclavicular joint arthritis. Methods The clinical data of 14 patients with symptomatic acromioclavicular joint arthritis treated by arthroscopic indirect distal clavicle resection between January 2020 and March 2021 were retrospectively analyzed. There were 5 males and 9 females with an average age of 46.3 years (range, 18-57 years). The 4 cases of left shoulder and 10 cases of right shoulder were accompanied with acromial impingement, without the history of shoulder trauma. The average disease duration was 20.4 months (range, 9-48 months), and the average visual analogue scale (VAS) score was 7.6 (range, 5-9) preoperatively. The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score before and after operation, further, the patient satisfaction rate was also calculated. Results All 14 patients were followed up 5-18 months, with an average of 13 months. There was no postoperative pain of acromioclavicular joint in 12 patients; 1 case had occasional mild pain, which could be controlled by painkillers. Moreover, there was only 1 acromioclavicular joint subluxation due to early fitness training at 2 weeks postoperatively, and the symptoms gradually relieved after 1 month of conservative treatments. The UCLA score was 22.1±6.2 preoperatively, which improved to 30.2±3.4 at last follow-up, showing significant difference (t=5.359, P<0.001). The patient satisfaction rate was 92.9%, with 12 excellent cases, 1 good case, and 1 fair case. Conclusion Arthroscopic distal clavicle resection for symptomatic acromioclavicular arthritis is a safe, reliable, and repeatable procedure.

Citation： YANG Qingjun, LU Wenqian, YOU Tian, ZHANG Xintao, ZHANG Wentao, LI Canfeng. Effectiveness of arthroscopic distal clavicle resection for symptomatic acromioclavicular joint arthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(6): 698-702. doi: 10.7507/1002-1892.202201088 Copy

1.	Kim JY, Bryant S, Gardner B, et al. Distal clavicle excision for acromioclavicular joint osteoarthritis using a fluoroscopic Kirschner wire guide. Arthrosc Tech, 2021, 10(2): e359-e365.
2.	Tang J, Zhao J. Arthroscopic distal clavicle resection through the supraspinatus fossa portal. Arthrosc Tech, 2020, 9(12): e2057-e2061.
3.	Gaillard J, Calò M, Nourissat G. Bipolar acromioclavicular joint resection. Arthrosc Tech, 2017, 6(6): e2229-e2233.
4.	Frigg A, Song D, Willi J, et al. Seven-year course of asymptomatic acromioclavicular osteoarthritis diagnosed by MRI. J Shoulder Elbow Surg, 2019, 28(10): e344-e351.
5.	Hohmann E, Tetsworth K, Glatt V. Open versus arthroscopic acromioclavicular joint resection: a systematic review and meta-analysis. Arch Orthop Trauma Surg, 2019, 139(5): 685-694.
6.	DeFroda SF, Nacca C, Waryasz GR, et al. Diagnosis and management of distal clavicle osteolysis. Orthopedics, 2017, 40(2): 119-124.
7.	Park TS, Lee KW. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint. Indian J Orthop, 2016, 50(4): 379-383.
8.	Hohmann E, Shea K, Scheiderer B, et al. Indications for arthroscopic subacromial decompression. A level Ⅴ evidence clinical guideline. Arthroscopy, 2020, 36(3): 913-922.
9.	Compagnoni R, Stoppani C, Menon A, et al. Management of acromioclavicular osteoarthritis in rotator cuff tears: A scoping review. Joints, 2021, 7(4): 199-204.
10.	Pensak M, Grumet RC, Slabaugh MA, et al. Open versus arthroscopic distal clavicle resection. Arthroscopy, 2010, 26(5): 697-704.
11.	Ringshawl ZY, Farooq M, Bhat AA, et al. Indirect arthroscopic distal clavicle resection: an institutional experience with midterm functional outcome. Ortop Traumatol Rehabil, 2021, 23(1): 9-14.
12.	Elzanie A, Varacallo M. Anatomy, Shoulder and Upper Limb, Deltoid Muscle. Treasure Island (FL): StatPearls Publishing, 2022. https://www.ncbi.nlm.nih.gov/books/NBK537056.
13.	Saccomanno MF, DE Ieso C, Milano G. Acromioclavicular joint instability: anatomy, biomechanics and evaluation. Joints, 2014, 2(2): 87-92.
14.	Sircana G, Saccomanno MF, Mocini F, et al. Anatomic reconstruction of the acromioclavicular joint provides the best functional outcomes in the treatment of chronic instability. Knee Surg Sports Traumatol Arthrosc, 2021, 29(7): 2237-2248.
15.	Franovic S, Pietroski A, Kuhlmann N, et al. Rockwood grade-III acromioclavicular joint separation: A cost-effectiveness analysis of treatment options. JB JS Open Access, 2021, 6(2): e20.00171. doi: 10.2106/JBJS.OA.20.00171.
16.	Chen YT, Wu KT, Jhan SW, et al. Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation? BMC Musculoskelet Disord, 2021, 22(1): 127. doi: 10.1186/s12891-021-03978-3.
17.	邓富元, 李忠, 刘俊才. 关节镜辅助双Endobutton “8” 字扣锁固定治疗RockwoodⅢ型急性肩锁关节脱位. 中国修复重建外科杂志, 2020, 34(9): 1125-1129.
18.	Park KD, Kim TK, Lee J, et al. Palpation versus ultrasound-guided acromioclavicular joint intra-articular corticosteroid injections: A retrospective comparative clinical study. Pain Physician, 2015, 18(4): 333-341.
19.	McLean M, Hoban K, Gupta R, et al. The epidemiology of acromioclavicular joint excision. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499018816521. doi: 10.1177/2309499018816521.
20.	Amirtharaj MJ, Wang D, McGraw MH, et al. Trends in the surgical management of acromioclavicular joint arthritis among board-eligible US orthopaedic surgeons. Arthroscopy, 2018, 34(6): 1799-1805.
21.	Kruse K, Yalizis M, Neyton L. Arthroscopic distal clavical resection using “Vis-à-Vis” Portal. Arthrosc Tech, 2016, 5(3): e667-e670.
22.	Levine WN, Barron OA, Yamaguchi K, et al. Arthroscopic distal clavicle resection from a bursal approach. Arthroscopy, 1998, 14(1): 52-56.
23.	De Rooij PP, Van Lieshout EMM, Schurink IJ, et al. Current practice in the management of acromioclavicular joint dislocations; a national survey in the Netherlands. Eur J Trauma Emerg Surg, 2021, 47(5): 1417-1427.
24.	Stine IA, Vangsness CT. Analysis of the capsule and ligament insertions about the acromioclavicular joint: a cadaveric study. Arthroscopy, 2009, 25(9): 968-974.
25.	Burns J. Editorial commentary: The “mumford” & sons: for distal clavicle excisions, what are our young surgeons doing, and how well are they doing it? Arthroscopy, 2018, 34(6): 1806-1808.

1. Kim JY, Bryant S, Gardner B, et al. Distal clavicle excision for acromioclavicular joint osteoarthritis using a fluoroscopic Kirschner wire guide. Arthrosc Tech, 2021, 10(2): e359-e365.
2. Tang J, Zhao J. Arthroscopic distal clavicle resection through the supraspinatus fossa portal. Arthrosc Tech, 2020, 9(12): e2057-e2061.
3. Gaillard J, Calò M, Nourissat G. Bipolar acromioclavicular joint resection. Arthrosc Tech, 2017, 6(6): e2229-e2233.
4. Frigg A, Song D, Willi J, et al. Seven-year course of asymptomatic acromioclavicular osteoarthritis diagnosed by MRI. J Shoulder Elbow Surg, 2019, 28(10): e344-e351.
5. Hohmann E, Tetsworth K, Glatt V. Open versus arthroscopic acromioclavicular joint resection: a systematic review and meta-analysis. Arch Orthop Trauma Surg, 2019, 139(5): 685-694.
6. DeFroda SF, Nacca C, Waryasz GR, et al. Diagnosis and management of distal clavicle osteolysis. Orthopedics, 2017, 40(2): 119-124.
7. Park TS, Lee KW. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint. Indian J Orthop, 2016, 50(4): 379-383.
8. Hohmann E, Shea K, Scheiderer B, et al. Indications for arthroscopic subacromial decompression. A level Ⅴ evidence clinical guideline. Arthroscopy, 2020, 36(3): 913-922.
9. Compagnoni R, Stoppani C, Menon A, et al. Management of acromioclavicular osteoarthritis in rotator cuff tears: A scoping review. Joints, 2021, 7(4): 199-204.
10. Pensak M, Grumet RC, Slabaugh MA, et al. Open versus arthroscopic distal clavicle resection. Arthroscopy, 2010, 26(5): 697-704.
11. Ringshawl ZY, Farooq M, Bhat AA, et al. Indirect arthroscopic distal clavicle resection: an institutional experience with midterm functional outcome. Ortop Traumatol Rehabil, 2021, 23(1): 9-14.
12. Elzanie A, Varacallo M. Anatomy, Shoulder and Upper Limb, Deltoid Muscle. Treasure Island (FL): StatPearls Publishing, 2022. https://www.ncbi.nlm.nih.gov/books/NBK537056.
13. Saccomanno MF, DE Ieso C, Milano G. Acromioclavicular joint instability: anatomy, biomechanics and evaluation. Joints, 2014, 2(2): 87-92.
14. Sircana G, Saccomanno MF, Mocini F, et al. Anatomic reconstruction of the acromioclavicular joint provides the best functional outcomes in the treatment of chronic instability. Knee Surg Sports Traumatol Arthrosc, 2021, 29(7): 2237-2248.
15. Franovic S, Pietroski A, Kuhlmann N, et al. Rockwood grade-III acromioclavicular joint separation: A cost-effectiveness analysis of treatment options. JB JS Open Access, 2021, 6(2): e20.00171. doi: 10.2106/JBJS.OA.20.00171.
16. Chen YT, Wu KT, Jhan SW, et al. Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation? BMC Musculoskelet Disord, 2021, 22(1): 127. doi: 10.1186/s12891-021-03978-3.
17. 邓富元, 李忠, 刘俊才. 关节镜辅助双Endobutton “8” 字扣锁固定治疗RockwoodⅢ型急性肩锁关节脱位. 中国修复重建外科杂志, 2020, 34(9): 1125-1129.
18. Park KD, Kim TK, Lee J, et al. Palpation versus ultrasound-guided acromioclavicular joint intra-articular corticosteroid injections: A retrospective comparative clinical study. Pain Physician, 2015, 18(4): 333-341.
19. McLean M, Hoban K, Gupta R, et al. The epidemiology of acromioclavicular joint excision. J Orthop Surg (Hong Kong), 2019, 27(1): 2309499018816521. doi: 10.1177/2309499018816521.
20. Amirtharaj MJ, Wang D, McGraw MH, et al. Trends in the surgical management of acromioclavicular joint arthritis among board-eligible US orthopaedic surgeons. Arthroscopy, 2018, 34(6): 1799-1805.
21. Kruse K, Yalizis M, Neyton L. Arthroscopic distal clavical resection using “Vis-à-Vis” Portal. Arthrosc Tech, 2016, 5(3): e667-e670.
22. Levine WN, Barron OA, Yamaguchi K, et al. Arthroscopic distal clavicle resection from a bursal approach. Arthroscopy, 1998, 14(1): 52-56.
23. De Rooij PP, Van Lieshout EMM, Schurink IJ, et al. Current practice in the management of acromioclavicular joint dislocations; a national survey in the Netherlands. Eur J Trauma Emerg Surg, 2021, 47(5): 1417-1427.
24. Stine IA, Vangsness CT. Analysis of the capsule and ligament insertions about the acromioclavicular joint: a cadaveric study. Arthroscopy, 2009, 25(9): 968-974.
25. Burns J. Editorial commentary: The “mumford” & sons: for distal clavicle excisions, what are our young surgeons doing, and how well are they doing it? Arthroscopy, 2018, 34(6): 1806-1808.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopic distal clavicle resection for symptomatic acromioclavicular joint arthritis

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