Skip to main content
SpringerLink
Log in

Asymptomatic acromioclavicular joint arthritis in arthroscopic rotator cuff tendon repair: a prospective randomized comparison study

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Hypothesis

Arthroscopic acromioclavicular joint (ACJ) resection for asymptomatic ACJ arthritis combined with rotator cuff repair leads to more satisfactory pain relief and decrease reoperation rate when inferiorly directed osteophytes present at the undersurface of ACJ.

Materials and methods

Between January 2006 and May 2008, a total of 83 patients (83 shoulders), 40 males and 43 females, who were planned to have arthroscopic repair of a tear measuring 1–3 cm in the anterior-posterior dimension with advanced ACJ arthritis with inferiorly directed osteophytes at the undersurface of the ACJ on MRI were entered into this study. Patients were randomized into two groups. Group 1 included 31 patients, who underwent arthroscopic distal clavicle resection combined with rotator cuff repair. Group 2 included 52 patients, who underwent isolated rotator cuff repair. Patients were evaluated preoperatively and postoperatively using the University of California Los Angeles (UCLA) score and the American Shoulder and Elbow Surgeons (ASES) score. Pain, tenderness on ACJ, and cross body adduction test were compared between groups.

Results

The mean follow-up was 31.7 months (range 34–38). The UCLA scores and ASES scores were lower in group 1 at week 6 (p < .05), and week 12 (p < .05), but higher at the last follow-up at 2 years (p < .05) postoperatively. VAS score was higher in group 1 at week 6 (p < .05), and at week 12 (p < .05), but lower in group 2 at the last follow-up (p < .05). Only in group 2, two (3.8%) cases developed ACJ pain during follow-up and one (1.9%) case underwent reoperation for additional ACJ resection.

Conclusions

This study shows that distal clavicle resection combined with rotator cuff repair for asymptomatic ACJ arthritis with inferiorly directed osteophytes lower functional scores due to temporary pain in early postoperative periods, but better functional outcomes with satisfactory pain relief and no reoperation rate were observed after 2 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Neer C (1990) Cuff tears, biceps lesions, and impingement. Shoulder reconstruction. Philadelphia, WB Saunders, pp 63–70

    Google Scholar 

  2. Edelson J (1996) Patterns of degenerative change in the acromioclavicular joint. J Bone Joint Surg Br Vol 78(2):242

    CAS  Google Scholar 

  3. Henry M, Liu S, Loffredo A (1995) Arthroscopic management of the acromioclavicular joint disorder: a review. Clin Orthop Relat Res 316:276

    PubMed  Google Scholar 

  4. Neer C, Poppen N (1987) Supraspinatus outlet. Orthop Trans 11:234

    Google Scholar 

  5. Cuomo F et al (1998) The influence of acromioclavicular joint morphology on rotator cuff tears* 1. J Shoulder Elbow Surg 7(6):555–559

    Article  CAS  PubMed  Google Scholar 

  6. NEER C (1983) Impingement lesions. Clin Orthop Relat Res 173:70

    PubMed  Google Scholar 

  7. Petersson C, Gentz C (1983) Ruptures of the supraspinatus tendon the significance of distally pointing acromioclavicular osteophytes. Clin Orthop Relat Res 174:143

    PubMed  Google Scholar 

  8. Kessel L, Watson M (1977) The painful arc syndrome. Clinical classification as a guide to management. J Bone Joint Surg Br 59(2):166

    CAS  PubMed  Google Scholar 

  9. Kuster M, Hales P, Davis S (1998) The effects of arthroscopic acromioplasty on the acromioclavicular joint. J Shoulder Elbow Surg 7(2):140–143

    Article  CAS  PubMed  Google Scholar 

  10. Gartsman G (1993) Arthroscopic resection of the acromioclavicular joint. Am J Sports Med 21(1):71

    Article  CAS  PubMed  Google Scholar 

  11. Rabalais R, McCarty E (2007) Surgical treatment of symptomatic acromioclavicular joint problems: a systematic review. Clin Orthop Relat Res 455:30

    Article  PubMed  Google Scholar 

  12. Cadet E, Ahmad C, Levine W (2006) The management of acromioclavicular joint osteoarthrosis: debride, resect, or leave it alone. Instr Course Lect 55:75

    PubMed  Google Scholar 

  13. Matthews L, Parks B, Pavlovich L (1999) Arthroscopic versus open distal clavicle resection: a biomechanical analysis on a cadaveric model. Arthrosc J Arthrosc Relat Surg 15(3):237–240

    Article  CAS  Google Scholar 

  14. Flatow E et al (1995) Arthroscopic resection of the distal clavicle with a superior approach. J Should Elb Surg/Am Should Elb Surg 4(1 Pt 1):41–50

    Google Scholar 

  15. Sher J et al (1995) Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg 77(1):10

    CAS  PubMed  Google Scholar 

  16. Stein B et al (2001) Detection of acromioclavicular joint pathology in asymptomatic shoulders with magnetic resonance imaging. J Shoulder Elbow Surg 10(3):204–208

    Article  CAS  PubMed  Google Scholar 

  17. DePalma A (1957) Degenerative changes in the sternoclavicular and acromioclavicular joints in various decades. Thomas, Springfield, IL

  18. Rathbun J, Macnab I (1970) The microvascular pattern of the rotator cuff. J Bone Joint Surg Br 52(3):540

    CAS  PubMed  Google Scholar 

  19. Watson M (1978) The refractory painful arc syndrome. J Bone Joint Surg Br Vol 60(4):544

    Google Scholar 

  20. Weber S (1999) Coplaning the acromioclavicular joint at the time of acromioplasty: a long-term study. Arthroscopy 15:555

    Article  Google Scholar 

  21. Fukuda K et al (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg 68(3):434

    CAS  PubMed  Google Scholar 

  22. Klimkiewicz J et al (1999) The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elbow Surg 8(2):119–124

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Jaehwa Kim, Juhwan Chung & Hyunsoo Ok

Authors
  1. Jaehwa Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juhwan Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyunsoo Ok
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jaehwa Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, J., Chung, J. & Ok, H. Asymptomatic acromioclavicular joint arthritis in arthroscopic rotator cuff tendon repair: a prospective randomized comparison study. Arch Orthop Trauma Surg 131, 363–369 (2011). https://doi.org/10.1007/s00402-010-1216-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-010-1216-y

Keywords

Search

Navigation