Reviewed by Dr. Ken Alleyne
The tip of the shoulder blade (scapula) that forms the roof of the shoulder joint is known as the acromion. Where this bone meets the collarbone (clavicle) is known as the acromioclavicular (or AC) joint. Normally, the tendons of the shoulder and the fluid-filled sac that surrounds it, the bursa, have plenty of room underneath the AC joint. However, overuse of the shoulder may lead to bursitis and tendonitis, collectively known as impingement. Impingement causes the tissues underneath the AC joint to be pinched against the bone, causing irritation and pain. Additionally, arthritis can develop in the shoulder as a result of overuse (Arthrosis) or autoimmune attack (Rheumatoid Arthritis). Physical therapy, medication, or cortisone injections are most often prescribed for shoulder pain; however, if these methods fail to provide relief, arthroscopic surgery may be necessary.
Removing the end of the clavicle closest to the acromion may help alleviate some pain and loss of motion caused by arthritis or impingement. Removing the last third of the clavicle allows it to be replaced by more flexible scar tissue, thereby eliminating the bone-on-bone rubbing that causes pain. The procedure often is accompanied by a bone spur removal, Debridement, or other procedures. A distal clavicle resection is one of the newer additions to shoulder arthroscopy.
Detailed Description
Specialist
Orthopedic surgeon
Procedure
Before the Procedure:
The patient's medical history and any possible allergies to medication are determined. The surgeon may order X Rays, an MRI, CT Scan, or EMG to look into the joint before the procedure. The patient is dressed in a hospital gown and anesthetized either locally or generally.
During the procedure:
A number of half-inch incisions will be made to allow the arthroscope to enter the shoulder joint. A sterile saline solution will be pumped into the joint both to cleanse it and to expand it for better visualization. The surgical staff may also pump air into the joint to create more room to see inside the joint. While watching a monitor that shows a magnified image of the inside of the shoulder, the surgeon guides the arthroscope to perform a number of procedures within the joint.
After removing any degenerative or damaged tissue around the AC joint and bursa (see Debridement) bone spurs from the acromion, or repairing the rotator cuff, the surgeon uses a surgical cutter to remove the last half-inch from the clavicle. The surgeon may then move the arm to test for impingement. The patient may be discharged following the procedure, or may remain in the hospital for one or two days.
