A 1999 narrative review by Shaffer covering diagnosis and treatment of the three most common painful AC joint conditions: primary osteoarthritis, posttraumatic arthritis, and distal clavicle osteolysis. The paper evaluates the diagnostic workup — including when imaging misleads — and compares open versus arthroscopic distal clavicle resection techniques and outcomes.
When evaluating AC joint pain, don't trust imaging alone — order a Zanca view, reproduce symptoms with cross-body adduction, then confirm the AC joint as the pain generator with a lidocaine injection before committing to surgery.
Before any distal clavicle resection, assess for instability: grade III+ injuries require coracoclavicular reconstruction, not isolated resection, and even grade II injuries with hypermobility are relative contraindications.
A 1999 narrative review by Shaffer covering diagnosis and treatment of the three most common painful AC joint conditions: primary osteoarthritis, posttraumatic arthritis, and distal clavicle osteolysis. The paper evaluates the diagnostic workup — including when imaging misleads — and compares open versus arthroscopic distal clavicle resection techniques and outcomes.
When evaluating AC joint pain, don't trust imaging alone — order a Zanca view, reproduce symptoms with cross-body adduction, then confirm the AC joint as the pain generator with a lidocaine injection before committing to surgery.
Before any distal clavicle resection, assess for instability: grade III+ injuries require coracoclavicular reconstruction, not isolated resection, and even grade II injuries with hypermobility are relative contraindications.