Arthroscopy of the acromioclavicular joint

For many years the Mumford procedure or open resection of the distal clavicle has been the procedure of choice for the treatment of recalcitrant acromioclavicular joint pain. With advancement in shoulder arthroscopy and bursoscopy, arthroscopic resection of the distal clavicle can reproduce similar excellent results, avoiding some of the risks of the open procedure, including joint instability and muscle weakness. The arthroscopist can select from two approaches, a direct or superior approach or the indirect or subacromial approach. Both approaches are effective if the resection is performed in a systematic fashion and the amount of resection measured post-operatively. The authors have attempted to describe the pertinent anatomy of the acromioclavicular joint, clinical indications, and surgical technique for arthroscopic resection of the distal clavicle.