Atraumatic osteolysis of the distal clavicle. Results of open surgical excision.

A group of 14 patients underwent 17 consecutive open surgical excisions of the distal clavicle for atraumatic osteolysis after having failed conservative treatment. All patients were men involved in weight training or heavy-lifting occupations. The diagnosis was based on no history of shoulder trauma, positive plain radiographs, and positive joint scintigraphy. All 14 patients were available for followup at an average of 25 months postoperatively. The UCLA Shoulder Rating Scale was used for evaluation. All patients reported full return to sports and employment at a satisfactory level. All results were rated as excellent (8) or good (9). Eleven of the 14 patients had bilateral involvement to some extent. One patient had undergone open excision of the contralateral distal clavicle before the study and 3 patients presented with bilateral symptoms and underwent staged bilateral excisions during the study. Seven patients presented with contralateral symptoms and radiographic involvement at latest followup after return to weight-lifting activities.