Arthroscopic resection of the outer end of the clavicle from a superior approach: a critical, quantitative, radiographic assessment of bone removal.

The technique of arthroscopic resection of the outer end of the clavicle through a superior approach is evaluated to determine whether adequate bone removal can be achieved. Furthermore, the results are compared with open resection. Twelve patients with osteolysis of the outer end of the clavicle refractory to conservative treatment underwent resection: six open and six arthroscopically through a superior approach. The distances from the acromial side of the AC joint to the lateral edge of the clavicle at its superior and inferior cortices were measured before and after surgery on anteroposterior radiographs. Bone removal was assessed by the difference between pre- and postoperative measurements. Satisfactory bone removal was possible arthroscopically and averaged 17 mm. This compared favorably with 18-mm average bone removal in the open group. Comparable pain relief and function were achieved in both groups. However, pain relief was achieved on average 3.4 months earlier in the arthroscopic group. Hospital stay was significantly shortened because the arthroscopic resections were outpatient procedures, whereas the open procedures had an average hospital stay of 3 days.