The medium-term results of acromioclavicular joint arthroscopy with chondral and meniscal debridement

Abstract

Purpose: Surgical management of a young patient with a stable but painful acromioclavicular (AC) joint but normal imagining is a challenging problem. A standard arthroscopic excision of distal clavicle seems too aggressive. An alternative procedure is arthroscopic debridement of the joint, particularly the often torn meniscus, and chondroplasty. This study demonstrates in younger patients the medium-term result of arthroscopic debridement of a painful AC joint. Methods: Fifty-three young adult patients with a stable but painful AC joint, and virtually normal magnetic resonance imaging (MRI) scan, had arthroscopic debridement of the AC joint. Follow-up was with questionnaire and American Shoulder and Elbow Surgeons Shoulder Score (ASES). Results: Mean age was 29 years (18–39), 41 male, 31 dominant arm. Twenty-two patients demonstrated additional shoulder pathology. Two patients had a later distal clavicle excision. Five patients had later surgery to other areas of the shoulder but had an asymptomatic AC joint. Thirty-eight patients completed the ASES questionnaire at mean 44 months (24–86) post-operation. The mean ASES score was 82.8 (52–100). There was no association between ASES score and AC joint disease severity found at operation ( p = 0.25). Seven patients had ongoing shoulder symptoms, although none were severe enough to warrant any treatment. Conclusion: In this young group of patients with arthroscopic AC joint debridement, most had good relief of the AC joint related symptoms. This is a worthwhile procedure in the young patient, with quick recovery, and does not preclude further AC joint surgery later.