Arthroscopic distal clavicle excision. Technique and early results

Since 1941, distal clavicle excision has been a reliable technique for alleviating pain caused by acromioclavicular joint arthritis. Disadvantages of the procedure include permanent shoulder weakness, a lengthy recovery time ranging from weeks to months before useful function of the extremity returns, and lack of cosmesis. By modifying the standard portals used to perform arthroscopic subacromial decompression, the authors have successfully excised the distal clavicle of ten consecutive patients. Using this arthroscopic technique, the surgical time averaged approximately one hour 40 minutes, blood loss was negligible, and there were no complications. Operations were performed in an outpatient setting. Five of ten patients missed work only on the day of surgery, and seven of ten patients required no formal physical therapy. All ten patients achieved a good or excellent result on the UCLA. Shoulder Scale for short-term follow-up evaluation. Postoperative radiographs documented adequate bone resection in all cases. In experienced hands, arthroscopic distal clavicle excision is an excellent substitute for the "open" procedure.