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Distal Clavicular Resection Worsens Outcomes in Rotator Cuff Repair: A National Database Study.

Joshua M Wiener1, Parshva A Sanghvi1, Kira A Smith2

  • 1Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Journal of Shoulder and Elbow Arthroplasty
|May 17, 2024
PubMed
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Distal clavicular resection (DCR) during rotator cuff repair (RCR) does not improve outcomes for existing acromioclavicular joint (ACJ) pain. Combining DCR with RCR increases the risk of chronic pain and ACJ instability.

Area of Science:

  • Orthopedic Surgery
  • Shoulder Surgery
  • Sports Medicine

Background:

  • Distal clavicular resection (DCR) is performed to treat acromioclavicular joint (ACJ) pain.
  • It is often performed concurrently with rotator cuff repair (RCR).

Purpose of the Study:

  • To investigate the relationship between DCR and RCR.
  • To evaluate the outcomes and complication rates of DCR when performed with RCR.

Main Methods:

  • Retrospective study utilizing TriNetX database.
  • Analysis of 46,534 patients undergoing RCR.
  • Cohorts stratified by timing of DCR relative to RCR and presence/absence of DCR.

Main Results:

  • 14.8% of RCR patients also underwent DCR.
Keywords:
Shoulderoutcomesrotator cuff tear

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  • Patients receiving RCR with DCR had higher rates of postoperative chronic pain (P < .0001).
  • Few patients with pre-existing ACJ pain required DCR post-RCR; minimal new ACJ pain developed in those without prior pain.

    • Conclusions:

    • Subsequent DCR is not typically required after RCR.
    • DCR offers no significant benefit for pre-existing ACJ pain when combined with RCR.
    • DCR increases the risk of ACJ instability and chronic pain.