Following non operative treatment for an arthritic AC joint, an AC joint resection may be discussed. This procedure is done as a keyhole operation and involves removing a segment of bone at the end of the clavicle (collarbone). Resection of a painful AC joint is very effective in relieving pain. The resected AC joint is replaced by fibrous scar tissue that takes the place of the worn out, inflammed joint.
In the past there was a tendency to take bone only off the clavicle in order to excise the AC joint. It has become apparent that some of these patients have excessive instability symptoms, especially in an anteroposterior direction due to compromising the posterosuperior capsular ligaments. Arthroscopic resection allows these important posterosuperior ligaments of the AC joint to be preserved avoiding problems with instability. Open surgery will always involve division of these important structures which then need to be repaired once the surgery is completed.
Dr Cutbush now removes approximately 5mm of bone from the distal clavicle and a small amount of bone from the medial acromion. Doing this greatly helps to avoid instability symptoms in his patients.
See also Following an AC Joint Resection