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A decreasing function describes a relationship where the output consistently declines as the input increases. This means that for any two input values, if one is greater than the other, the corresponding output is smaller. Mathematically, a function f is decreasing on an interval I if for every x1 < x2​ in I, f (x1) > f (x2). This type of behavior is visually identified on a graph that slopes downward from left to right.The nature of a function can be analyzed by calculating...
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Related Experiment Video

Updated: Feb 3, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
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Does Distal Clavicle Resection Decrease Pain or Improve Shoulder Function in Patients With Acromioclavicular Joint

Jie Wang1, Jian-Xiong Ma, Shao-Wen Zhu

  • 1J. Wang, S.-W. Zhu, H.-B. Jia, X.-L. Ma, Department of Orthopaedics, Tianjin Hospital, Tianjin, China J.-X. Ma, X.-L. Ma, Department of Orthopaedics Institute, Tianjin Hospital, Tianjin, China.

Clinical Orthopaedics and Related Research
|October 19, 2018
PubMed
Summary
This summary is machine-generated.

Distal clavicle resection offers no benefit for rotator cuff tears with acromioclavicular joint arthritis and may cause instability. This procedure is not recommended for these patients, highlighting the need for further research.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Rheumatology

Background:

  • Acromioclavicular (AC) joint arthritis is a common cause of shoulder pain, often co-occurring with rotator cuff disease.
  • The necessity of distal clavicle resection in patients with rotator cuff tears and concurrent AC joint arthritis remains a subject of debate.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs).
  • To evaluate the impact of distal clavicle resection on outcome scores, shoulder range of motion (ROM), joint pain, tenderness, instability, and reoperation risk in patients with rotator cuff tears and AC joint arthritis.

Main Methods:

  • Systematic search of PubMed, EMBASE, and Cochrane databases for RCTs comparing rotator cuff repair plus distal clavicle resection versus isolated rotator cuff repair.
  • Inclusion criteria: full- or partial-thickness rotator cuff tears with concomitant AC joint arthritis and a minimum 2-year follow-up.
  • Data extraction, methodological quality assessment, and statistical analysis using fixed- or random-effect models based on heterogeneity (I² index).

Main Results:

  • No significant differences were found in American Shoulder and Elbow Surgeons (ASES) scores, visual analog scale (VAS) scores, Constant scores, or shoulder ROM between the groups.
  • No difference in AC joint pain or tenderness was observed.
  • Acromioclavicular joint instability was noted exclusively in the group that underwent distal clavicle resection.
  • Reoperation rates were similar between the surgical groups.

Conclusions:

  • Distal clavicle resection does not improve clinical outcomes or shoulder ROM in patients with rotator cuff tears and AC joint arthritis.
  • The procedure may increase the risk of AC joint instability.
  • Arthroscopic distal clavicle resection is not recommended for this patient population; further high-quality RCTs are warranted.