Open versus arthroscopic acromioclavicular joint resection: a retrospective comparison study

Area of Science:

• Orthopedic Surgery
• Shoulder Joint Procedures
• Minimally Invasive Surgery

Background:

• Acromioclavicular joint (ACJ) resection is a common procedure for shoulder pain.
• Both open and arthroscopic techniques are utilized, with varying reported outcomes.
• Comparative data on long-term results between these methods is essential for clinical decision-making.

Purpose of the Study:

• To compare the efficacy and outcomes of open versus arthroscopic acromioclavicular joint (ACJ) resection.
• To evaluate pain relief, functional improvement, and complication rates for both surgical approaches.

Main Methods:

• Retrospective review of 103 patients (105 shoulders) undergoing ACJ resection between 2000-2005.
• Group A: 81 shoulders (arthroscopic direct approach); Group B: 24 shoulders (open resection).
• Outcomes assessed via Constant score, subjective shoulder value, pain, and function, with a mean follow-up of 51 months.

Main Results:

• Both groups demonstrated significant improvement in Constant scores post-surgery (P < .0001).
• No statistically significant difference in postoperative normalized Constant scores between arthroscopic and open groups (P = .47).
• High rates of pain improvement (94% arthroscopic, 92% open); revision rates were similar (6.2% arthroscopic, 4.2% open).

Conclusions:

• Arthroscopic and open ACJ resection yield comparable outcomes.
• Incomplete excision and distal clavicle regrowth are primary reasons for revision surgery.
• The study did not establish a causal link between arthroscopic technique and distal clavicle regrowth, despite a small observed percentage.