ARTHROSCOPIC MANAGEMENT OF THE ACROMIOCLAVICULAR JOINT DISORDER - A REVIEW

Acromioclavicular joint symptoms may originate from either osteolysis or osteoarthritis. Initial treatment consists of 6 to 12 months of phy sical therapy, nonsteroidal antiinflammatory drugs, avoidance of exace rbating activities, and other conservative modalities. The majority of patients respond well, but a few remain unable to return to their pre vious or desired activity levels. Previously this group of patients un derwent open resection of the distal clavicle. [The approach violates the deltotrapezial fascia, weakening the surgically treated extremity, which has caused controversy in the literature.] Even without complic ations, the recovery and time away from work is prolonged. With advanc es in arthroscopic techniques, resection of the distal clavicle and me dial aspect of the acromion has become possible with minimal invasiven ess. The arthroscopic technique offers the advantages of rapid rehabil itation with excellent functional results. Several different modificat ions of 2 basic approaches, the bursal and direct superior, have been described by various authors. The authors sought to examine critically and review the data supporting the choice of arthroscopic surgery rat her than an open technique, as well as the advantages of 1 arthroscopi c approach over the other.