Open Versus Arthroscopic Distal Clavicle Resection

Manual Physical Therapy for Injection-Confirmed Nonacute Acromioclavicular Joint Pain

“…The operative approach, a distal clavicle excision (DCE), or "Mumford" procedure, is commonly performed. 9,21,49 However, since the inception of the DCE in 1941 there have been no clinical trials to our knowledge to define the role of the procedure relative to no intervention or lowerrisk interventions. 7,26,44 Current evidence regarding DCE as a treatment option for nonacute ACJ pain is therefore derived from studies comparing different surgical techniques.…”

“…7,26,44 Current evidence regarding DCE as a treatment option for nonacute ACJ pain is therefore derived from studies comparing different surgical techniques. 9,19,21,35,49,53 Surgical complications for these procedures occur in 0% to 64% of cases and include infection, heterotopic ossification, joint instability, suprascapular neuropathy, and distal clavicle fracture, in addition to complications associated with anesthesia. 3,9,12,24,59 Eskola et al 20 investigated long-term results of patients managed with DCE for complaints of ACJ pain and reported that nearly 1 in 3 patients had poor long-term outcomes and advised against DCE for patients with higher functional demands on their shoulders.…”

Comparison between open and arthroscopic procedures for lateral clavicle resection

“…So far, few studies on patient-related outcomes comparing these approaches have been published, all showing excellent results in function and pain for both approaches [5][6][7][8][9]. Although one study found a better pain score outcome in favour of an arthroscopic approach [8], no relevant differences were found in other studies [5][6][7]9].…”

“…Although one study found a better pain score outcome in favour of an arthroscopic approach [8], no relevant differences were found in other studies [5][6][7]9]. Thus, a preferable approach based on patient-related outcome measures can, so far, not be determined [5][6][7][8].…”

“…In 2010, after reviewing 17 studies, Pensak et al [9] concluded that both approaches are safe and beneficial for the treatment of recurrent AC pain, but the arthroscopic approach was associated with higher success rate than the open approach, with a good or excellent outcome in 79 % for the open approach (n =287) and 91 % for the arthroscopic approach (n =142). Four comparative studies were found in the literature, which found no difference in shoulder function at final follow-up between LCR by an open and arthroscopic approach, although different questionnaires were used [5][6][7][8].…”