Background:There is a paucity of type 2 superior labrum anterior and posterior (SLAP) surgical outcomes with prospective data.Purpose:To prospectively analyze the clinical outcomes of the arthroscopic treatment of type 2 SLAP tears in a young, active patient population, and to determine factors associated with treatment success and failure.Study Design:Case-control study; Level of evidence, 3.Methods:Over a 4-year period, 225 patients with a type 2 SLAP tear were prospectively enrolled. Two sports/shoulder-fellowship-trained orthopaedic surgeons performed repairs with suture anchors and a vertical suture construct. Patients were excluded if they underwent any additional repairs, including rotator cuff repair, labrum repair outside of the SLAP region, biceps tenodesis or tenotomy, or distal clavicle excision. Dependent variables were preoperative and postoperative assessments with the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Western Ontario Shoulder Inst...

A Prospective Analysis of 179 Type 2 Superior Labrum Anterior and Posterior Repairs Outcomes and Factors Associated With Success and Failure

Purpose The purpose was to compare open and arthroscopic acromioclavicular joint (ACJ) resection. Methods We retrospectively reviewed 103 patients (105 shoulders) who underwent ACJ resection between 2000 and 2005. There were 56 women and 47 men with a mean age of 48 years. The mean duration of follow-up was 51 months (range, 15 to 91 months). Arthroscopic ACJ resection by use of a direct approach was performed in 81 shoulders (group A), and open ACJ resection was performed in 24 shoulders (group B). Results were graded according to pain relief both subjectively and objectively with cross-body adduction testing and direct palpation of the ACJ, subjective shoulder value, Constant score, and improved function. Results The Constant scores increased from 50 (range, 34 to 65) to 89 (range, 39 to 100) in group A ( P P P = .47). Pain with cross-body adduction testing and palpation of the ACJ improved in 76 shoulders (94%) in group A and 22 shoulders (92%) in group B. No patients had signs or symptoms of ACJ anteroposterior instability. Revision ACJ resection was performed in 5 patients (5 shoulders [6.2%]) in group A and 1 shoulder (4.2%) in group B ( P = .37). The radiographs of the patients who underwent revision showed that 3 patients (3.7%) from group A had regrowth of the distal clavicle; in addition, 2 patients (2.5%) from group A and 1 patient (4.3%) from group B had incomplete distal clavicle excision. Conclusions This study did not show a significant difference in the outcome between arthroscopic and open ACJ resection. Incomplete excision and regrowth of the distal clavicle are the most common causes of revision. Although only the arthroscopic group showed a small percentage of patients (3.7%) with regrowth of the distal clavicle, the number is too small to assume that this complication is the result of the arthroscopic technique only. Level of Evidence Level IV, therapeutic case series.

Open Versus Arthroscopic Acromioclavicular Joint Resection: A Retrospective Comparison Study

Background:The treatment of symptomatic acromioclavicular joint (ACJ) injury in the rotator cuff (RC) tear has not been well clarified.Purpose:To compare the clinical results between patients who had distal clavicle resection (DCR) and those who did not during RC repair.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:From August 2008 to December 2009, a total of 56 consecutive patients (58 shoulders) were included. All patients had either a full-thickness or high-grade (>50%) RC tear, ACJ tenderness, arthritic change visible on plain radiographs, and a positive ACJ lidocaine injection test the day before surgery. Patients were randomized into 2 groups: DCR and RC repair (DCR+RCR group) and RC repair only (isolated RCR). Evaluation was performed preoperatively, at 6 months postoperatively, and at a final follow-up a minimum of 24 months postoperatively using the American Shoulder and Elbow Surgeons (ASES) score, the Constant shoulder score, range of motion examination, and pain visua...

Arthroscopic Distal Clavicle Resection in Symptomatic Acromioclavicular Joint Arthritis Combined With Rotator Cuff Tear A Prospective Randomized Trial

Purpose: Coplaning removes medial acromial spurs and portions of the distal clavicle with an arthroscopic subacromial decompression (ASD). Concerns exist that this violates inferior acromioclavicular (AC) ligaments and increases AC joint mobility, resulting in long-term problems. The purpose of this study was to re-evaluate 3 cohorts of patients who underwent ASD with various degrees of coplaning and to determine if late AC joint tenderness or reoperation had occurred. Type of Study: Nonrandomized control study. Methods: Eighty-one patients undergoing ASD were divided into 3 groups. Group 1 (24) underwent removal of inferior clavicle osteophytes, group 2 (34) had a distal clavicle hemiresection with up to 50% of the articular cartilage removed, and group 3 (23) had complete distal clavicle resection. Radiographs, charts, and arthroscopic videotapes were reviewed to determine the amount of clavicle removed. Follow-up evaluations included Constant-Murley, American Shoulder and Elbow Surgeons (ASES), SANE, and Rowe shoulder scores with special attention given to AC joint pain and additional procedures. Results: The average patient age was 46 years (range, 19 to 81 years) and follow-up was 73 months. At follow-up, the average Constant, ASES, Row, and SANE scores were: for group 1, 97.1, 97.5, 96.9, and 95.8, respectively; for group 2, 95.1, 97.4, 96, and 92.8, respectively; and for group 3, 96.3, 98.3, 96.1, and 95.7. No patient required additional shoulder surgery. Conclusions: Coplaning did not increase AC joint symptoms, compromise clinical results, or lead to additional surgery at an average follow-up of 6 years. Level of Evidence: Level IV, therapeutic case series study.

Long-term Results of Acromioclavicular Joint Coplaning

https://www.sportsmed.theclinics.com/article/S0278-5919(03)00015-2/pdf

The role of the acromioclavicular joint in impingement syndrome.

Midterm results of arthroscopic co-planing of the acromioclavicular joint.

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Midterm results of arthroscopic co-planing of the acromioclavicular joint.