R Lenz1, P C Kreuz, T Tischer. 1. Sektion Sportorthopädie und Prävention, Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberanerstr. 142, 18057, Rostock, Deutschland.
Abstract
OBJECTIVE: Arthroscopic resection of the painful and degenerative altered acromioclavicular (AC) joint without destabilization of the joint and therefore pain relief and improvement in function. INDICATIONS: Conservative failed therapy of painful AC joint osteoarthritis. Impingement caused by caudal AC joint osteophytes. Lateral clavicular osteolysis. CONTRAINDICATIONS: General contraindications (infection, local tumor, coagulation disorders), higher grade instability of the AC joint (resection only together with stabilization). SURGICAL TECHNIQUE: Diagnostic glenohumeral arthroscopy. Treatment of accompanying lesions (subacromial impingement, rotator cuff, long head of biceps). Subacromial arthroscopy with bursectomy (partial) and visualization of the AC joint. Resection of caudal osteophytes. Localization of the anterior portal using a spinal needle in the outside-in technique. Resection of 2-3 mm of the acromial side and the 3-4 mm of the clavicular side with shaver/acromionizer. RESULTS: An isolated open AC joint resection was performed in 9 studies and an arthroscopic resection in 6 studies. Good and very good results were obtained in 79% (range 54-100%) in open resection and 91% (range 85-100%) in arthroscopic resections. Patients were able to return to activities of daily life more quickly after arthroscopic resections than after open surgery.
OBJECTIVE: Arthroscopic resection of the painful and degenerative altered acromioclavicular (AC) joint without destabilization of the joint and therefore pain relief and improvement in function. INDICATIONS: Conservative failed therapy of painful AC joint osteoarthritis. Impingement caused by caudal AC joint osteophytes. Lateral clavicular osteolysis. CONTRAINDICATIONS: General contraindications (infection, local tumor, coagulation disorders), higher grade instability of the AC joint (resection only together with stabilization). SURGICAL TECHNIQUE: Diagnostic glenohumeral arthroscopy. Treatment of accompanying lesions (subacromial impingement, rotator cuff, long head of biceps). Subacromial arthroscopy with bursectomy (partial) and visualization of the AC joint. Resection of caudal osteophytes. Localization of the anterior portal using a spinal needle in the outside-in technique. Resection of 2-3 mm of the acromial side and the 3-4 mm of the clavicular side with shaver/acromionizer. RESULTS: An isolated open AC joint resection was performed in 9 studies and an arthroscopic resection in 6 studies. Good and very good results were obtained in 79% (range 54-100%) in open resection and 91% (range 85-100%) in arthroscopic resections. Patients were able to return to activities of daily life more quickly after arthroscopic resections than after open surgery.
Authors: Paula M Ludewig; Vandana Phadke; Jonathan P Braman; Daniel R Hassett; Cort J Cieminski; Robert F LaPrade Journal: J Bone Joint Surg Am Date: 2009-02 Impact factor: 5.284
Authors: Bassem Elhassan; Mehmet Ozbaydar; David Diller; Daniel Massimini; Laurence D Higgins; Jon J P Warner Journal: Arthroscopy Date: 2009-11 Impact factor: 4.772