Midterm results of arthroscopic co-planing of the acromioclavicular joint

Background: There has been recent concern about longterm morbidity associat ed with arthroscopic co-planing of the acromioclavicular joint in the treat ment of impingement syndrome. Objective: The purpose of this study was to assess he results of the co-pla ning procedure, special attention being paid to acromioclavicular joint mor bidity. Methods: The study included 56 patients who were operated on by the senior author. Outcomes were evaluated both objectively and subjectively through p hysical examinations and telephone surveying. Each patient had subacromial decompression at the time of the index surgery. Other concomitant arthrosco pic procedures included rotator cuff repair and labral debridement or repai r. Results: Average Follow-up was 4 years (range, 2-7 years). Thirty-five (95% ) of 37 patients had no subjective pain and no objective tenderness to dire ct palpation or compression of the acromioclavicular joint. The joint was n ot clinically hypermobile in comparison with that on he opposite side in an y patient. In all, 95% of patients had good or excellent results in terms o f he University of California at Los Angeles Shoulder Score. Of the 2 patie nts who did have pain and tenderness at the acromioclavicular joint, both h ad had multiple operations on their shoulders before the index procedure. N ineteen patients were not examined clinically but did complete a telephone survey; these IP patients were not symptomatic at the acromioclavicular joi nt. Conclusions: To fully treat impingement syndrome, the surgeon should remove osteophytes under the lateral clavicle and medial acromion. With good tech nique, the surgeon can leave the anterior, posterior, and superior acromioc lavicular joint capsule intact. We conclude hat fbr appropriate clinical in dications, beveling he inferior 20% to 25% of the clavicle to make it co-pl anar with he decompressed acromion is safe and is not an etiologic factor i n acromioclavicular joint pain or instability.