This systematic review (Medline + EMBASE, 26 clinical trials) compares outcomes of open distal clavicle excision, direct arthroscopic excision, and indirect (bursal) arthroscopic excision for AC joint arthritis and osteolysis refractory to nonoperative care. It asks whether any technique produces superior results and examines the effect of concomitant procedures, prior trauma, resection amount, and coplaning on outcomes.
When planning distal clavicle excision, counsel patients with posttraumatic AC pathology (prior Grade I–II separation or distal clavicle fracture) that poor outcomes are roughly 3× more likely than in atraumatic disease.
If you violate the AC joint during subacromial decompression, the literature is split on whether to coplane or complete a full excision — but partial resection carries a real risk of new AC symptoms, so have a plan before you start.
This systematic review (Medline + EMBASE, 26 clinical trials) compares outcomes of open distal clavicle excision, direct arthroscopic excision, and indirect (bursal) arthroscopic excision for AC joint arthritis and osteolysis refractory to nonoperative care. It asks whether any technique produces superior results and examines the effect of concomitant procedures, prior trauma, resection amount, and coplaning on outcomes.
When planning distal clavicle excision, counsel patients with posttraumatic AC pathology (prior Grade I–II separation or distal clavicle fracture) that poor outcomes are roughly 3× more likely than in atraumatic disease.
If you violate the AC joint during subacromial decompression, the literature is split on whether to coplane or complete a full excision — but partial resection carries a real risk of new AC symptoms, so have a plan before you start.