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THE OUTCOME OF OPEN EXCISION OF THE ACROMIO-CLAVICULAR JOINT IN ISOLATED ACROMIO-CLAVICULAR JOINT OSTEOARTHRITIS



Abstract

Aims: To evaluate the outcome of open excision of the Acromio-Clavicular Joint (ACJ) in isolated Acromio-Clavicular Joint osteoarthritis and compare it with the published rates for arthroscopic intervention.

Introduction: Anectdotally this operation has been reported as very successful. There are no reviews of this particular operation in the literature. Arthroscopic excision has been advocated as being successful in > 90% of patients in repeated studies.

Methods: A two year period of theatre records produced a group of patients who had undergone this procedure. Case-notes were obtained and the patients with isolated ACJ were identified. Information on patient demographics, duration of symptoms, length of operation, operative complications and follow up were obtained. The patients were contacted and asked to fill out a DASH form. They were invited to a research clinic for clinical review.

Results: 31 patients with 32 isolated osteoarthritic ACJs were identified. Ratio of men to women was 22:9. Mean age at surgery was 48 years. Duration of symptoms before surgery was 105 weeks (mean). Mean time of surgery was 17 minutes. 80% were discharged from follow up by 4 months, mean follow up being 12 weeks. Complications were limited to 2 superficial wound infections. One patient did not have resolution of symptoms.

DASH score results were excellent in all bar one of those returned.

Conclusion: This simple operation has been shown to be effective in 96.9% of patients. The complication rate was 6.2%. Patient satisfaction is high.

These results are comparable to the best results of arthroscopic ACJ Excision.

Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland